Evaluation of cord blood total nucleated and CD34(+) cell content, cell dose, and 8-allele HLA match by patient ancestry Journal Article

Authors: Barker, J. N.; Mazis, C. M.; Devlin, S. M.; Davis, E.; Maloy, M. A.; Naputo, K.; Nhaissi, M.; Wells, D.; Scaradavou, A.; Politikos, I.
Article Title: Evaluation of cord blood total nucleated and CD34(+) cell content, cell dose, and 8-allele HLA match by patient ancestry
Abstract: How cord blood (CB) CD34+ cell content and dose and 8-allele HLA match vary by patient ancestry is unknown. We analyzed cell content, dose, and high-resolution HLA-match of units selected for CB transplantation (CBT) by recipient ancestry. Of 544 units (286 infused, 258 next-best backups) chosen for 144 racially diverse adult patients (median weight, 81 kg), the median total nucleated cell (TNC) and CD34+cell +contents were higher for Europeans than for non-Europeans: 216 × 107versus 197 × 107 (P = .002) and 160 × 105 versus 132 × 105 (P = .007), respectively. There were marked cell content disparities among ancestry groups, with units selected for Africans having the lowest TNC (189 × 107) and CD34+ cell (122 × 105) contents. Units for non-Europeans were also more HLA-mismatched (P = .017). When only the 286 transplanted units were analyzed, the adverse effect of reduced cell content was exacerbated by the higher weights in some groups. For example, northwestern Europeans (high patient weight, high unit cell content) had the best-dosed units, and Africans (high weight, low unit cell content) had the lowest. In Asians, low cell content was partially compensated for by lower weight. Marked differences in 8-allele HLA-match distribution were also observed by ancestry group; for example, 23% of units for northwestern Europeans were 3/8 to 4/8 HLA-matched, compared with 40% for southern Europeans, 46% for white Hispanics, and 51% for Africans. During the study period, 20 additional patients (17 non-Europeans; median weight, 98 kg) did not undergo CBT owing to the lack of a suitable graft. CB extends transplantation access to most patients, but racial disparities exist in cell content, dose, and HLA match. © 2019 American Society for Transplantation and Cellular Therapy
Keywords: adult; aged; major clinical study; cord blood; cord blood stem cell transplantation; cell therapy; umbilical cord blood; cell count; donor selection; cd34 selection; graft recipient; hispanic; hla system; african; hla match; ancestry group; cell component; human; male; female; article; evaluation study; ancestry; cd34+ cell content; tnc content
Journal Title: Biology of Blood and Marrow Transplantation
Volume: 26
Issue: 4
ISSN: 1083-8791
Publisher: Elsevier Inc.  
Date Published: 2020-04-01
Start Page: 734
End Page: 744
Language: English
DOI: 10.1016/j.bbmt.2019.11.017
PUBMED: 31756534
PROVIDER: scopus
Notes: Article -- Source: Scopus
Citation Impact
MSK Authors
  1. Juliet N Barker
    296 Barker
  2. Molly Anna Maloy
    246 Maloy
  3. Eric Nelson Davis
    16 Davis
  4. Sean McCarthy Devlin
    442 Devlin
  5. Deborah Sessions Wells
    23 Wells
  6. Christopher M Mazis
    20 Mazis
  7. Kristine Anne Naputo
    21 Naputo