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
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Citation Impact
MSK Authors
  1. Nancy Kernan
    476 Kernan
  2. Sergio Andres Giralt
    746 Giralt
  3. Doris Ponce
    183 Ponce
  4. Juliet N Barker
    294 Barker
  5. Molly Anna Maloy
    242 Maloy
  6. Eric Nelson Davis
    16 Davis
  7. Sean McCarthy Devlin
    436 Devlin
  8. Deborah Sessions Wells
    23 Wells
  9. Parastoo Bahrami Dahi
    178 Dahi
  10. Christopher M Mazis
    20 Mazis
  11. Kristine Anne Naputo
    21 Naputo
  12. Candice Jenna Cooper
    9 Cooper