Impact of detectable measurable residual disease on umbilical cord blood transplantation

[en] The impact of measurable residual disease (MRD) on cord blood transplantation (CBT) outcomes has remained debated. To address this issue, we assessed the impact of measurable MRD at CBT on outcomes in large cohort of patients with acute leukemia. Inclusion criteria included adult patients with acute myeloid (AML) or acute lymphoblastic leukemia (ALL), CBT as first allo-HCT in first or second complete remission (CR) at transplantation, and known MRD status at the time of CBT. Data from 506 patients were included in the analysis. Among them, 317 patients had AML and 189 had ALL. Positive MRD was reported in 169 (33%) patients while the remaining 337 patients were MRD negative at CBT. At 2 years, relapse incidence was 18% in patients with MRD negativity vs 33% in those with MRD positivity at transplantation (P <.001). Two-year leukemia-free survival (LFS) and overall survival (OS) were 57% and 60%, respectively, in MRD negative patients, vs 38% (P <.001) and 48% (P =.004), respectively, in those with MRD positivity. There was no interaction between the impact of MRD on OS and LFS and diagnosis (ie, ALL vs AML), single or double CBT, and reduced-intensity or myeloablative conditioning. On multivariate analysis, MRD positivity was associated with a higher risk of relapse (HR = 1.8, P =.003), comparable non-relapse mortality (P =.44), worse LFS (HR = 1.4, P =.008) and a trend towards worse OS (HR = 1.3, P =.065). In conclusion, these data suggest that novel strategies that are aiming to achieve MRD negativity at CBT are needed for leukemic patients with positive MRD pre-CBT. © 2020 Wiley Periodicals LLC.

Disciplines :

Hematology

Author, co-author :

Baron, Frédéric ; Université de Liège - ULiège > I3-Hematology

Labopin, M.; EBMT Paris Study Office/CEREST-TC, Paris, France, Service d'Hématologie Clinique et de Thérapie cellulaire, APHP, Hôpital Saint Antoine, Paris, France, Centre de Recherche Saint-Antoine (CRSA), INSERM, Paris, France, Sorbonne Université, Paris, France

Ruggeri, A.; Ospedale San Raffaele s.r.l., Haematology and BMT, Milan, Italy, Eurocord, Hospital Saint Louis, AP-HP, and IUH University Paris VII, France

Monacord, Centre Scientifique De Monaco; Monaco, Monaco

Sierra, J.; Department of Hematology, Hospital Santa Creu i Sant Pau, Barcelona, Spain

Robinson, S.; Department of Haematology, Bristol Haematology Oncology Centre, University Hospital Bristol, Bristol, United Kingdom

Labussière-Wallet, H.; Service Hematologie, Centre Hospitalier Lyon Sud, Lyon, France

Potter, M.; Royal Marsden Hospital, Leukaemia Myeloma Units, London, United Kingdom

Ribera, J.-M.; Department of Clinical Hematology, ICO-Hospital Universitari Germans Trias i Pujol Josep Carreras Research Institute, Badalona, Spain

Deconinck, E.; Service d'Hématologie, Hopital Jean Minjoz, Besancon, France

More authors (7 more)

Language :

English

Title :

Impact of detectable measurable residual disease on umbilical cord blood transplantation

Publication date :

September 2020

Journal title :

American Journal of Hematology

ISSN :

0361-8609

eISSN :

1096-8652

Publisher :

Wiley-Liss Inc.

Volume :

Issue :

Pages :

1057-1065

Peer reviewed :

Peer Reviewed verified by ORBi

Available on ORBi :

since 03 September 2020

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