A long-term study of 651 adults with acute myeloid leukemia (AML) receiving reduced-intensity (RIC) or nonmyeloablative conditioning (NMA) transplantation has found comparable four-year survival with umbilical cord blood and mismatched unrelated donors: 47.9% vs. 50.5%, respectively (p=0.81). There was no significant difference in non-relapse mortality between cord blood and both matched unrelated donor (HR: 1.05; 95% CI: 0.62-1.78; p=0.85) and mismatched unrelated donor (HR: 1.58; 95% CI: 0.88-2.83; p=0.13). At 2 years, overall chronic GVHD was significantly lower with umbilical cord blood than with mismatched unrelated donors (p=0.004) and matched unrelated donors (p<0.001) The researchers concluded that in the setting of RIC/NMA transplantation, umbilical cord blood is a valid alternative graft source compared to mismatched unrelated donor grafts in the absence of a matched unrelated donor or with need for urgent HCT.
Malard F, et al. Biol Blood Marrow Transplant