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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