TY - JOUR
T1 - RIC versus MAC UCBT in adults with AML
T2 - A report from Eurocord, the ALWP and the CTIWP of the EBMT
AU - Baron, Frédéric
AU - Ruggeri, Annalisa
AU - Beohou, Eric
AU - Labopin, Myriam
AU - Sanz, Guillermo
AU - Milpied, Noel
AU - Michallet, Mauricette
AU - Bacigalupo, Andrea
AU - Blaise, Didier
AU - Sierra, Jorge
AU - Socié, Gérard
AU - Cornelissen, Jan J.
AU - Schmid, Christoph
AU - Giebel, Sebastian
AU - Gorin, Norbert Claude
AU - Esteve, Jordi
AU - Ciceri, Fabio
AU - Savani, Bipin N.
AU - Mohty, Mohamad
AU - Gluckman, Eliane
AU - Nagler, Arnon
PY - 2016
Y1 - 2016
N2 - Nonrelapse mortality (NRM) is the first cause of treatment failure after unrelated cord blood transplantation (UCBT) following myeloablative conditioning (MAC). In the last decade, reduced-intensity conditioning (RIC) regimens have been developed with the aim of reducing NRM and allowing older patients and those with medical comorbidities to benefit from UCBT. The aim of the current retrospective study was to compare transplantation outcomes of acute myeloid leukemia (AML) patients given UCBT after either RIC or MAC. Data from 894 adults with AML receiving a single or double UCBT as first allograft from 2004 to 2013 at EBMT centers were included in this study. 415 patients were given UCBT after RIC while 479 patients following a MAC. In comparison to MAC recipients, RIC recipients had a similar incidence of neutrophil engraftment and of acute and chronic graft-versus-host disease (GVHD). However, RIC recipients had a higher incidence of disease relapse and a lower NRM, translating to comparable leukemia-free (LFS), GVHD-free, relapse-free survival (GRFS) and overall survival (OS). These observations remained qualitatively similar after adjusting for differences between groups in multivariate analyses. In conclusion, these data suggest that LFS and OS are similar with RIC or with MAC in adults AML patients transplanted with UCBT. These observations could serve as basis for a future prospective randomized study.
AB - Nonrelapse mortality (NRM) is the first cause of treatment failure after unrelated cord blood transplantation (UCBT) following myeloablative conditioning (MAC). In the last decade, reduced-intensity conditioning (RIC) regimens have been developed with the aim of reducing NRM and allowing older patients and those with medical comorbidities to benefit from UCBT. The aim of the current retrospective study was to compare transplantation outcomes of acute myeloid leukemia (AML) patients given UCBT after either RIC or MAC. Data from 894 adults with AML receiving a single or double UCBT as first allograft from 2004 to 2013 at EBMT centers were included in this study. 415 patients were given UCBT after RIC while 479 patients following a MAC. In comparison to MAC recipients, RIC recipients had a similar incidence of neutrophil engraftment and of acute and chronic graft-versus-host disease (GVHD). However, RIC recipients had a higher incidence of disease relapse and a lower NRM, translating to comparable leukemia-free (LFS), GVHD-free, relapse-free survival (GRFS) and overall survival (OS). These observations remained qualitatively similar after adjusting for differences between groups in multivariate analyses. In conclusion, these data suggest that LFS and OS are similar with RIC or with MAC in adults AML patients transplanted with UCBT. These observations could serve as basis for a future prospective randomized study.
KW - AML
KW - Myeloablative
KW - Reduced-intensity
KW - Transplantation
KW - Unrelated cord blood
UR - http://www.scopus.com/inward/record.url?scp=84978687317&partnerID=8YFLogxK
U2 - 10.18632/oncotarget.9599
DO - 10.18632/oncotarget.9599
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C2 - 27250025
AN - SCOPUS:84978687317
SN - 1949-2553
VL - 7
SP - 43027
EP - 43038
JO - Oncotarget
JF - Oncotarget
IS - 28
ER -
