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

Overview

MeSH Major

  • HLA Antigens
  • Lymphocyte Depletion
  • Myelodysplastic Syndromes
  • Stem Cell Transplantation
  • T-Lymphocytes
  • Transplantation, Isogeneic

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.

publication date

  • April 9, 2019

Research

keywords

  • Academic Article

Identity

Language

  • eng

PubMed Central ID

  • PMC6457223

Digital Object Identifier (DOI)

  • 10.1182/bloodadvances.2018028662

PubMed ID

  • 30917950

Additional Document Info

start page

  • 939

end page

  • 944

volume

  • 3

number

  • 7