Contribution of non-infectious transplantation-related complications to the outcome of hematopoietic stem cell transplantation in patients with acute myeloid leukemia: a single institute analysis.

Abstract

Cord blood (CB) is becoming an increasingly attractive alternative stem cell source for allogeneic hematopoietic stem cell transplantation (HSCT), but the outcomes of CB transplantation (CBT) are inconsistent. In the present study, we compared non-infectious transplantation-related complications (NITRCs) post-CBT in patients with acute myeloid leukemia (AML) with those following related bone marrow and peripheral blood transplantation and unrelated BM transplantation. We analyzed 108 patients with AML who received HSCT at the Konan Kosei Hospital between 1992 and 2013. After a median follow-up of 74 months, the 3-year overall survival (OS) rate was 49.4 % with no differences between graft sources. The cumulative incidence of total NITRCs was 36 % at day 100. After adjusted analyses, patients with NITRCs showed significantly decreased OS [relative risk (RR) 3.51; p < 0.001) and increased non-relapse mortality (NRM) (RR 6.49; p < 0.001) compared with patients without NITRCs. Although the cumulative NITRC incidence did not differ among transplantation groups, NRM in patients with NITRCs was significantly lower in CB recipients than in other graft recipients (11.2 versus 68.4 %, p = 0.015). These data suggest that NITRCs contribute significantly to the outcome of HSCT and that the low virulence of NITRCs favored CBT for adult AML.