Cord blood transplantation is associated with good outcomes in secondary Acute Myeloid Leukaemia in first remission.

Abstract

We conducted a retrospective survey within the European Society for Blood and Marrow Transplantation (EBMT) registry to assess the outcomes of cord blood transplantation (CBT) in secondary acute myeloid leukaemia (sAML). Inclusion criteria consisted of ≥18years of age, sAML, first CBT between 2002 and 2016, and either first complete remission (CR) or active disease at CBT. One hundred forty-six patients met the study inclusion criteria. Status at transplantation was first CR (n=97), primary refractory sAML (n=30) or relapsed (n=19) sAML. Neutrophil engraftment was achieved in 118 patients while the remaining 25 patients (17%) failed to engraft. This includes 13% of patients transplanted in first CR versus 30% of those transplanted with active disease (P=0.008). Two-year incidences of relapse were 25% in first CR patients versus 36% in those with advanced disease (P=0.06) while 2-year incidences of nonrelapse mortality were 35% and 49% (P=0.03), respectively. At 2-year overall survival, leukaemia-free survival and graft-versus-host disease (GVHD)-free relapse-free survival were 42% vs. 19% (P<0.001), 40% vs. 16% (P<0.001), and 26% vs. 12% (P=0.002) in first CR patients versus those with advanced disease, respectively. We report here the first study of CBT in a large cohort of sAML patients. Main observation was that CBT rescued approximately 40% of patients with sAML in first CR.