# Outcome of initial cord blood transplantation with FM80TBI as conditioning regimen for acute myeloid leukemia

## TL;DR

This study shows that cord blood transplantation with FM80TBI is effective for older AML patients or those with health issues.

## Contribution

The study evaluates the FM80TBI conditioning regimen for cord blood transplantation in older AML patients.

## Key findings

- 87.9% of patients achieved neutrophil engraftment by day 42.
- 3-year overall survival was 67.1% with low non-relapse mortality.
- Patients in complete remission had significantly better survival rates.

## Abstract

Outcomes of allogeneic stem cell transplantation in older patients with acute myeloid leukemia (AML) have been unsatisfactory. At our center, cord blood transplantation (CBT) using FM80TBI has been implemented in older patients or those with comorbidities. We conducted a retrospective single-center study to evaluate transplantation outcomes in patients with AML who underwent CBT following FM80TBI. The FM80TBI regimen consisted of fludarabine (125 or 150 mg/m²), melphalan (80 mg/m²), and total-body irradiation (4 Gy). This study included 58 patients. The median follow-up period was 38 months. The median age at transplant was 67 (52–73) years. At the time of CBT, 39.7% of all patients having an Eastern Cooperative Oncology Group performance status of ≤ 2 did not achieve complete remission (CR), 25.9% had adverse cytogenetic risk, and 53.4% were positive for Wilms tumor gene-1 messenger RNA in peripheral blood. Neutrophil engraftment by day 42 was achieved in 87.9% of patients. The 3-year overall survival (OS) was 67.1%, the 3-year non-relapse mortality was 14.4%, and the 3-year cumulative incidence of relapse was 20.0%. Patients with CR status at the time of CBT had significantly better 3-year OS than those with non-CR status (86.8% vs. 42.4%, P < 0.05). The cumulative incidences of Grade II–IV acute graft-versus-host disease (GVHD) at day 100 and chronic GVHD at 2 years were 29.4% and 15.0%, respectively. Although this was a single-center retrospective study, the outcomes of CBT for older patients with AML or those with comorbidities following FM80TBI were favorable.

The online version contains supplementary material available at 10.1007/s00277-026-06888-3.