10 January 2022

Cord blood transplantation is a promising treatment tool for people with refractory or relapsed acute myeloid leukaemia (R/R AML), a Japanese study has found.

Researchers from Osaka University compared two cell transplantation strategies in a subset of AML patients who were not in remission.

Fewer than 10% of R/R AML patients live for five years or more, which means new therapies are urgently needed.

While haematopoietic stem cell transplantation (HSCT) can be effective at curing the cancer, patients who are not in remission at the time of transplant often relapse. HLA-matched related donor transplant (MRDT) is now considered the ideal in this situation, the researchers say.

Cord blood transplantation (CBT) has been found to have comparable effects to MRDT. What’s more, previous studies have suggested it may be more effective for R/R AML patients that do not meet the ideal conditions for HCST.

The Osaka University team examined survival data of 1,738 adult non-remission R/R AML patients who were given CBT and compared them with 713 similar patients who were given MRDT. The team examined the five-year progression-free survival (PFS) rates of these Japanese patients.

They found the MRDT-treated patients had an 18.1% five-year PFS compared to a 25.2% five-year PFS among the CBT-treated patients.

Yoshimitsu Shimomura, lead author of the study in Leukemia, said: “CBT compared with MDRT had a more pronounced decrease in relapse rate than increase in [non-relapse mortality].”

The authors say the data support CBT as a potential superior alternative to MRDT for this subset of leukaemia patients. Future studies will investigate if genetic factors play any role in patients’ responses to these two transplantation methods.

Source:

Shimomura Y, Sobue T, Hirabayashi S, Kondo T, Mizuno S, Kanda J, Fujino T, Kataoka K, Uchida N, Eto T, Miyakoshi S, Tanaka M, Kawakita T, Yokoyama H, Doki N, Harada K, Wake A, Ota S, Takada S, Takahashi S, Kimura T, Onizuka M, Fukuda T, Atsuta Y, Yanada M. (2021) “Comparing cord blood transplantation and matched related donor transplantation in non-remission acute myeloid leukaemia.” Leukemia, doi: 10.1038/s41375-021-01474-0

Link: https://www.nature.com/articles/s41375-021-01474-0   

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