Has umbilical cord blood transplantation for AML become mainstream?

Abstract

We discuss outcomes after umbilical cord blood (UCB) transplantation (UCBT) for patients with acute myeloid leukemia (AML) and compare these outcomes to results after transplantation of other allogeneic graft sources. Survival after UCBT has improved considerably over the past 10 years. Multiple retrospective studies using either myeloablative or reduced intensity conditioning have shown disease-free survival after UCBT that is comparable to that of matched related or unrelated donors. Improved unit selection, conditioning, graft manipulation, and supportive care are all emerging strategies to further improve outcomes, although disease status and center expertise remain key components of successful UCBT outcome. UCBT should be considered in all high-risk AML patients in whom allogeneic stem cell transplantation is indicated but who lack a matched related or unrelated donor. UCBT can thereby now be thought of as a 'mainstream' treatment of high-risk AML.