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Updated comparable efficacy of cord blood transplantation for chronic myelomonocytic leukaemia: a nationwide study

Bone Marrow Transplantation (2024)Cite this article

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Abstract

Chronic myelomonocytic leukaemia (CMML) is a haematological malignancy with a poor prognosis. Allogeneic haematopoietic stem cell transplantation remains the only curative approach. Without human leucocyte antigen-matched related sibling donors, the optimal alternative donor has yet to be established. Although unrelated bone marrow transplantation (UBMT) has been extensively studied, cord blood transplantation (CBT) for CMML remains largely unexplored. This nationwide retrospective study compared the outcomes of UBMT and single-unit umbilical CBT in patients with CMML. This study included 118 patients who underwent their first allo-HSCT during 2013–2021. Of these, 50 received BMT (UBMT group), while 68 underwent CBT (CBT group). The primary endpoint was the 3-year overall survival (OS). There were comparable 3-year OS rates between the UBMT (51.0%, 95% confidence interval [CI]: 34.1–65.5%) and CBT (46.2%, 95% CI: 33.2–58.1%; P = 0.60) groups. In the inverse probability of treatment weighting analysis, CBT did not show significantly improved outcomes compared with UBMT regarding the 3-year OS rate (hazard ratio 0.97 [95% CI: 0.57–1.66], P = 0.91). Thus, CBT may serve as an alternative to UBMT for patients with CMML. Further research is necessary to optimise transplantation strategies and enhance outcomes in patients with CMML undergoing CBT.

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Fig. 1: Flowchart of patient selection and study design.
Fig. 2: Transplant outcomes of the patients from the UBMT and CBT groups.
Fig. 3: Forest plot for hazard ratios of overall survival in subgroup analyses.

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Data availability

The data for this study are not publicly available because of ethical restrictions that exceed the scope of the recipient’s or donor’s consent for research use in the registry.

Change history

  • 19 April 2024

    A duplicate sentence has been deleted.

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Acknowledgements

The authors extend their gratitude to the physicians and staff at the transplant centres who contributed to the data collection in the Transplant Registry Unified Management Program of the Japan Society of Hematopoietic Cell Transplantation.

Author information

Authors and Affiliations

  1. Department of Hematology, Yokohama Municipal Citizen’s Hospital, Yokohama, Japan

    Shuhei Kurosawa

  2. Department of Hematology, Kobe City Hospital Organization Kobe City Medical Center General Hospital, Kobe, Japan

    Yoshimitsu Shimomura

  3. Department of Environmental Medicine and Population Science, Graduate School of Medicine, Osaka University, Osaka, Japan

    Yoshimitsu Shimomura

  4. Department of Hematology, National Center for Global Health and Medicine, Tokyo, Japan

    Ken Ishiyama

  5. Department of Haematopoietic Cell Therapy, Niigata University Medical and Dental Hospital, Niigata, Japan

    Kyoko Fuse

  6. Kyoto Innovation Center for Next Generation Clinical Trials and iPS Cell Therapy, Kyoto University Hospital, Kyoto, Japan

    Yutaka Shimazu

  7. Hematology Division, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital, Tokyo, Japan

    Noriko Doki

  8. Department of Hematology, Federation of National Public Service Personnel Mutual Aid Associations, Toranomon Hospital, Tokyo, Japan

    Naoyuki Uchida

  9. Department of Hematology, Kanagawa Cancer Center, Yokohama, Japan

    Masatsugu Tanaka

  10. Department of Hematology/Oncology, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan

    Satoshi Takahashi

  11. Division of Hematology, Department of Medicine, Keio University School of Medicine, Tokyo, Japan

    Masatoshi Sakurai

  12. Department of Hematology, Nagano Red Cross Hospital, Nagano, Japan

    Hikaru Kobayashi

  13. Department of Hematology, Hiroshima Red Cross Hospital & Atomic-bomb Survivors Hospital, Hiroshima, Japan

    Yuta Katayama

  14. Leukemia Research Center, Saiseikai Maebashi Hospital, Maebashi, Japan

    Satoru Takada

  15. Department of Hematology and Oncology, Konan Kosei Hospital, Konan, Japan

    Kazutaka Ozeki

  16. Department of Hematology, Osaka Metropolitan University Hospital, Osaka, Japan

    Hirohisa Nakamae

  17. Japanese Red Cross Kanto-Koshinetsu Block Blood Center, Tokyo, Japan

    Fumihiko Ishimaru

  18. Division of Hematology, Jichi Medical University, Shimotsuke, Japan

    Yoshinobu Kanda

  19. Department of Hematology and Oncology, Research Institute for Radiation Biology and Medicine, Hiroshima University, Hiroshima, Japan

    Tatsuo Ichinohe

  20. Japanese Data Center for Hematopoietic Cell Transplantation, Nagakute, Japan

    Yoshiko Atsuta

  21. Department of Registry Science for Transplant and Cellular Therapy, Aichi Medical University School of Medicine, Nagakute, Japan

    Yoshiko Atsuta

  22. Transfusion and Cell Therapy Unit, Nagasaki University Hospital, Nagasaki, Japan

    Hidehiro Itonaga

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  1. Shuhei Kurosawa
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  2. Yoshimitsu Shimomura
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SK and Y Shimomura designed the research study, analysed the data, and wrote the manuscript. KI, KF, Y Shimazu, and HI critically reviewed the data and manuscript. All authors contributed to data collection and approved the final version of the manuscript.

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Correspondence to Shuhei Kurosawa.

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Kurosawa, S., Shimomura, Y., Ishiyama, K. et al. Updated comparable efficacy of cord blood transplantation for chronic myelomonocytic leukaemia: a nationwide study. Bone Marrow Transplant (2024). https://doi.org/10.1038/s41409-024-02223-4

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