Umbilical cord blood infusion enhances hematopoietic recovery and improves survival in elderly AML patients with chemotherapy-induced myelosuppression: a retrospective study

Vollständiger Abstract

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Elderly AML (Acute Myeloid Leukemia) patients exhibit increased mortality owing to chemotherapy-induced myelosuppression. Umbilical cord blood (UCB) contains hematopoietic stem/progenitor cells and a spectrum of regenerative cytokines that actively promote hematopoietic regeneration. We investigated whether umbilical cord blood (UCB) infusion enhances hematopoietic recovery in elderly AML patients who experience chemotherapy-induced myelosuppression during post-chemotherapy supportive care. Methods We retrospectively analyzed 95 elderly patients with AML in complete remission (CR1) who previously developed grade III–IV chemotherapy-induced myelosuppression. The control group (n=60) received standard supportive care, including granulocyte colony-stimulating factor (G-CSF), blood product transfusions, and antibiotic therapy. The experimental group (n = 35) underwent infusion of unrelated umbilical cord blood (UCB; CD34 + cells ≥2×10 6 /kg) within 24 hours post - chemotherapy, along with standard supportive care. Results Neutrophil recovery duration (≥1.0×10 9 /L) was reduced in the UCB group (16 VS 23 days, P<0.01). Platelet recovery (≥50×10 9 /L) was also shorter (13 days vs. 19 days, P<0.01), though hemoglobin recovery (≥70 g/L) did not differ significantly (18 days vs. 21 days, P>0.05). The incidence of grade III–IV infections decreased to 31.43% (vs. 55.00%, P<0.05), that of bleeding events decreased to 11.43% (vs. 33.33%, P<0.05), that of transfusion-related allergic reactions decreased to 17.14% (vs. 26.67%, P<0.05), and chemotherapy delay/reduction rates decreased to 14.29% (vs. 35.00%, P<0.05). The overall survival (OS) was significantly longer in the UCB group, and the 2-year relapse-free survival (RFS) was higher (P<0.05). The most common adverse events were transfusion-related (e.g., rash and transient fever). Graft-versus-host disease (GVHD) was not observed in the UCB group. These findings indicate that UCB infusion enhances hematopoietic recovery, reduces complications, and improves the survival of elderly patients with AML after chemotherapy, likely through the synergistic effects of CD34 + cells and cytokines.