title: The impact of pre-transplant minimal residual disease on outcome of intensified myeloablative cord blood transplant for acute myeloid leukemia in first or second complete remission.
abstract: The impact of pretransplant minimal residual disease (MRD) on outcome of myeloablative cord blood transplant (CBT) for acute myeloid leukemia (AML) in complete remission (CR) has not been reported. Seventy-two AML patients were assessed for MRD before CBT, and the majority (84.7%) of these patients received single-unit CBT. All patients received intensified myeloablative conditioning with BUCY2 or TBICY plus high-dose cytarabine, and graft-versus-host disease (GVHD) prophylaxis consisted of cyclosporine and mycophenolate mofetil. The cumulative incidences of neutrophil and platelet engraftment, acute or chronic GVHD were comparable between MRD-negative and MRD-positive groups. The cumulative incidence of transplant-related mortality (TRM) and relapse did not differ signiﬁcantly between the two cohorts (25.6% vs. 32.5%, 16.1% vs. 19.2%; p = 0.52, 0.61). There were no apparent differences in 3-year overall survival (OS) (68.9% in MRD-negative group and 57.9% in MRD-positive group, p = 0.31) and 3-year leukemia-free survival (LFS) (62.5% in MRD-negative group and 52.7% in MRD-positive group, p = 0.42) between both groups. The current study suggests that AML patients in morphological CR1 or CR2 who have detectable MRD might benefit from unrelated CBT with intensified myeloablative conditioning.
authors.affiliation: a Department of Hematology , Anhui Provincial Hospital, Anhui Medical University , Hefei , China.
authors.forename: Changcheng
authors.initials: C
authors.lastname: Zheng
authors.affiliation: a Department of Hematology , Anhui Provincial Hospital, Anhui Medical University , Hefei , China.
authors.forename: Xiaoyu
authors.initials: X
authors.lastname: Zhu
authors.affiliation: a Department of Hematology , Anhui Provincial Hospital, Anhui Medical University , Hefei , China.
authors.forename: Baolin
authors.initials: B
authors.lastname: Tang
authors.affiliation: a Department of Hematology , Anhui Provincial Hospital, Anhui Medical University , Hefei , China.
authors.forename: Lei
authors.initials: L
authors.lastname: Zhang
authors.affiliation: a Department of Hematology , Anhui Provincial Hospital, Anhui Medical University , Hefei , China.
authors.forename: Liangquan
authors.initials: L
authors.lastname: Geng
authors.affiliation: a Department of Hematology , Anhui Provincial Hospital, Anhui Medical University , Hefei , China.
authors.forename: Huilan
authors.initials: H
authors.lastname: Liu
authors.affiliation: a Department of Hematology , Anhui Provincial Hospital, Anhui Medical University , Hefei , China.
authors.forename: Zimin
authors.initials: Z
authors.lastname: Sun
mesh_terms: D000293:Adolescent; D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001706:Biopsy; D001853:Bone Marrow / Q000473:pathology; D002648:Child; D002675:Child, Preschool; D036101:Cord Blood Stem Cell Transplantation / Q000009:adverse effects; D005260:Female; D006085:Graft Survival; D006086:Graft vs Host Disease / Q000209:etiology / Q000517:prevention & control; D006801:Humans; D015470:Leukemia, Myeloid, Acute / Q000401:mortality / Q000473:pathology* / Q000628:therapy*; D008297:Male; D018365:Neoplasm, Residual / Q000473:pathology*; D012008:Recurrence; D012074:Remission Induction; D019172:Transplantation Conditioning; D014184:Transplantation, Homologous; D016896:Treatment Outcome; D055815:Young Adult
keywords: Acute myeloid leukemia; cord blood transplant; intensified myeloablative conditioning; minimal residual disease