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
    613 Giralt
  2. Doris Ponce
    149 Ponce
  3. Miguel-Angel Perales
    456 Perales
  4. Juliet N Barker
    251 Barker
  5. Eric Nelson Davis
    9 Davis
  6. Sean McCarthy Devlin
    353 Devlin
  7. Deborah Sessions Wells
    18 Wells
  8. Parastoo Bahrami Dahi
    124 Dahi
  9. Satyajit   Kosuri
    23 Kosuri
  10. Tara Faye Wolff
    4 Wolff
  11. Brian Carl Shaffer
    63 Shaffer
  12. Christopher M Mazis
    11 Mazis
  13. Kristine Anne Naputo
    10 Naputo