Synapse - Racial disparities in access to HLA-matched unrelated donor transplants: A prospective 1312-patient analysis

Racial disparities in access to HLA-matched unrelated donor transplants: A prospective 1312-patient analysis Journal Article

Authors:	Barker, J. N.; Boughan, K.; Dahi, P. B.; Devlin, S. M.; Maloy, M. A.; Naputo, K.; Mazis, C. M.; Davis, E.; Nhaissi, M.; Wells, D.; Cooper, C.; Ponce, D. M.; Kernan, N.; Scaradavou, A.; Giralt, S. A.; Papadopoulos, E. B.; Politikos, I.
Article Title:	Racial disparities in access to HLA-matched unrelated donor transplants: A prospective 1312-patient analysis
Abstract:	Availability of 8/8 HLA-allele matched unrelated donors (URDs) is a barrier for ethnic and racial minorities. We prospectively evaluated receipt of 8/8 HLA-allele matched URD or either 7/8 URD or cord blood (CB) transplants by patient ancestry from 2005 to 2017. Matched URDs were given priority if they were available. Of 1312 patients, 723 (55%) received 8/8 URD, 219 (17%) 7/8 URD, 319 (24%) CB, and 51 (4%) had no 7/8 or 8/8 URD or CB graft. Europeans were more likely to receive an 8/8 URD transplant than non-Europeans (67% vs 33%) and less likely to have no URD or CB graft (1% vs 9%). Southern Europeans received 8/8 URD transplants (41%) at rates similar to those of Asians (34%) and white Hispanics (35%); Africans were the least likely (18%) to undergo 8/8 URD transplantation. CB and 7/8 URDs extended transplant access to all groups. In 742 recent patients, marked racial disparity in 8/8 URD access between groups observed in earlier years persisted with only a modest increase in the percentage of 8/8 URD transplants. Of 78 recent African patients, 46% received a CB transplant and 14% had no 7/8 or 8/8 URD or CB graft. Increasing registry size has not resolved the racial disparity in URD access, which emphasizes the importance of alternative graft sources.
Keywords:	survival; outcomes; ethnicity; hematopoietic-cell transplantation; availability; cord-blood transplantation
Journal Title:	Blood Advances
Volume:	3
Issue:	7
ISSN:	2473-9529
Publisher:	American Society of Hematology
Date Published:	2019-04-09
Start Page:	939
End Page:	944
Language:	English
ACCESSION:	WOS:000463904400002
DOI:	10.1182/bloodadvances.2018028662
PROVIDER:	wos
PMCID:	PMC6457223
PUBMED:	30917950
Notes:	Article -- Source: Wos