Cord blood transplantation (CBT) is an alternative donor transplantation method and has the advantages of rapid availability and the possibility of inducing a more potent graft-versus-leukemia effect, leading to a lower relapse rate for patients with non-remission relapse and refractory acute myeloid leukemia (R/R AML). This study aimed to investigate the impact of CBT, compared to human leukocyte antigen-matched related donor transplantation (MRDT). This study included 2451 adult patients with non-remission R/R AML who received CBT (1738 patients) or MRDT (713 patients) between January 2009 and December 2018. Five-year progression-free survival (PFS) and the prognostic impact of CBT were evaluated using a propensity score (PS) matching analysis. After PS matching, the patient characteristics were well balanced between the groups. The five-year PFS was 25.2% (95% confidence interval [CI]: 21.2–29.5%) in the CBT group and 18.1% (95% CI: 14.5–22.0%) in the MRDT group (P = 0.009). The adjusted hazard ratio (HR) was 0.83 (95% CI: 0.69–1.00, P = 0.045); this was due to a more pronounced decrease in the relapse rate (HR: 0.78, 95% CI: 0.69–0.89, P < 0.001) than an increase in the NRM (1.42, 1.15–1.76, P = 0.001). In this population, CBT was associated with a better 5-year PFS than MRDT after allogeneic HSCT.

脐带血移植 (CBT) 是一种可供选择的供体移植方法，具有快速获得性和可能诱导更有效的移植物抗白血病效应的优点，从而导致非缓解复发和难治性急性患者的复发率较低髓性白血病 (R/R AML)。本研究旨在调查 CBT 与人类白细胞抗原匹配相关供体移植 (MRDT) 相比的影响。本研究包括 2009 年 1 月至 2018 年 12 月期间接受 CBT（1738 名患者）或 MRDT（713 名患者）的 2451 名非缓解 R/R AML 成年患者。五年无进展生存期 (PFS) 和 CBT 的预后影响使用倾向评分（PS）匹配分析进行评估。在 PS 匹配后，各组之间的患者特征得到了很好的平衡。P  = 0.009）。调整后的风险比 (HR) 为 0.83 (95% CI: 0.69–1.00, P  = 0.045)；这是由于复发率（HR：0.78, 95% CI: 0.69–0.89, P  < 0.001）比 NRM 增加（1.42, 1.15–1.76, P  = 0.001）更明显。在该人群中，CBT 与异基因 HSCT 后的 5 年 PFS 比 MRDT 更好。