Conditioning-adapted Methotrexate in Cord Blood Transplantation for High-risk Acute Myeloid Leukemia: A Nationwide Japanese Cohort Analysis
A nationwide Japanese cohort study of 1,311 adults with high-risk acute myeloid leukemia undergoing first single-unit cord blood transplantation found rapid, comparable neutrophil engraftment across methotrexate dose groups, with two-year overall survival of 48.5% and disease-free survival of 44.1%. Low-dose methotrexate was associated with more chronic graft-versus-host disease and poorer chronic GVHD-free and relapse-free survival in chemotherapy-based myeloablative and fludarabine-based reduced-intensity regimens, without reducing relapse. In total-body-irradiation-based myeloablative regimens, greater methotrexate exposure reduced grade II–IV acute GVHD and improved GVHD-free and relapse-free survival. Standard-dose methotrexate generally offered the best balance between GVHD prevention and survival in the other conditioning groups, supporting regimen-specific rather than uniformly reduced dosing.
Style rédactionnelFactuel
Predominantly factual observational cohort analysis reporting statistical associations and transplant outcomes, with limited interpretation of clinical implications.





