Prospective evaluation of unrelated donor cord blood and haploidentical donor access reveals graft availability varies by patient ancestry: Practical implications for donor selection Journal Article


Authors: Kosuri, S.; Wolff, T.; Devlin, S. M.; Byam, C.; Mazis, C. M.; Naputo, K.; Davis, E.; Paulson, J.; Nhaissi, M.; Wells, D. S.; Dahi, P.; Giralt, S. A.; Jakubowski, A.; Perales, M. A.; Shaffer, B. C.; Scaradavou, A.; Ponce, D. M.; Barker, J. N.
Article Title: Prospective evaluation of unrelated donor cord blood and haploidentical donor access reveals graft availability varies by patient ancestry: Practical implications for donor selection
Abstract: The availability of cord blood (CB) and haploidentical (haplo) donors in all patient populations is not established. We have investigated the addition of haplo-CD34+ cells to CB grafts (haplo-CBT) to speed myeloid engraftment. Thus, we have prospectively assessed CB and haplo donor availability in adult patients without 8/8 HLA-allele matched unrelated donors (URDs). Analysis of 89 patients eligible for haplo-CBT revealed 4 distinct patient groups. First, 6 patients (7% of total, 33% non-European) underwent CBT only as they had no suitable family members to type. In group 2, 49 patients (45% non-European) received haplo-CBT using the first haplo donor chosen. Group 3 (n = 21, 76% non-European) underwent CBT with/without haplo. In this group, the first haplo donor chosen failed clearance in 20 patients and transplantation was too urgent to permit donor evaluation in 1. Fifty-three haplo donors were evaluated (2 to 6 per patient) for 21 group 3 patients, and 43 of 53 (81%) haplos failed clearance for predominantly medical and/or psychosocial reasons. Group 4, (n = 13, 85% non-European with a high median weight of 96 kilograms) had no CB grafts with/without no haplo donors. Overall, African patients had the worst donor availability with only 65% having a suitable CB graft and only 44% having a suitable haplo donor. Additionally, in non-European patients, a greater number of haplos required evaluation/patient to secure a suitable haplo graft. Although these data should be confirmed in a larger study, it suggests that there are barriers to the availability of both CB and haplo grafts in adult patients without 8/8 URDs, especially in those with African ancestry, and has multiple practical implications for patient management. © 2017
Keywords: unrelated donors; cord blood transplantation; haploidentical donors
Journal Title: Biology of Blood and Marrow Transplantation
Volume: 23
Issue: 6
ISSN: 1083-8791
Publisher: Elsevier Inc.  
Date Published: 2017-06-01
Start Page: 965
End Page: 970
Language: English
DOI: 10.1016/j.bbmt.2017.03.001
PROVIDER: scopus
PUBMED: 28263918
DOI/URL:
Notes: Article -- Export Date: 2 June 2017 -- Source: Scopus
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MSK Authors
  1. Sergio Andres Giralt
    756 Giralt
  2. Doris Ponce
    186 Ponce
  3. Miguel-Angel Perales
    588 Perales
  4. Juliet N Barker
    296 Barker
  5. Eric Nelson Davis
    16 Davis
  6. Sean McCarthy Devlin
    444 Devlin
  7. Deborah Sessions Wells
    23 Wells
  8. Parastoo Bahrami Dahi
    184 Dahi
  9. Satyajit   Kosuri
    28 Kosuri
  10. Tara Faye Wolff
    4 Wolff
  11. Brian Carl Shaffer
    89 Shaffer
  12. Christopher M Mazis
    20 Mazis
  13. Kristine Anne Naputo
    21 Naputo