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Unrelated donor hematopoietic cell transplantation: factors associated with a better HLA match. Biol Blood Marrow Transplant 2008 Dec;14(12):1334-40 PMID: 19041054 PMCID: PMC3319684

Pubmed ID

19041054

Abstract

The impact of non-HLA patient factors on the match of the selected unrelated donor (URD) for hematopoietic cell transplantation (HCT) has not been fully evaluated. National Marrow Donor Program (NMDP) data for 7486 transplants using peripheral blood stem cells (PBSCs) or bone marrow from years 2000 to 2005 were evaluated using multivariate logistic regression to identify independent non-HLA patient factors associated with completing a more closely matched URD transplant. Advanced (intermediate- and late-stage) disease was significantly associated with an increased likelihood of transplant using a less-matched (partially matched or mismatched) donor. Additionally, Black patients were 2.83 times, Asian patients 2.05 times, and Hispanic patients 1.73 times more likely to have a less-matched HCT donor than Caucasian patients. Younger patients, HCT at lower volume centers, and in earlier years had significantly higher likelihood of having a less HLA matched URD transplant. Our analysis provides encouraging evidence of HLA matching improvement in recent years. Initiating a patient's URD search early in the disease process, especially for patients from non-Caucasian racial and ethnic groups, will provide the best likelihood for identifying the best available donor and making informed transplant decisions.

Author List

Dehn J, Arora M, Spellman S, Setterholm M, Horowitz M, Confer D, Weisdorf D

Author

Mary M. Horowitz MD, MS Center Director, Professor in the Medicine department at Medical College of Wisconsin




Scopus

2-s2.0-56549129073   34 Citations

MESH terms used to index this publication - Major topics in bold

Adolescent
Adult
Age Factors
Aged
Anemia, Aplastic
Bone Marrow Transplantation
Child
Child, Preschool
Common Variable Immunodeficiency
Continental Population Groups
Donor Selection
Female
HLA Antigens
Hematologic Neoplasms
Humans
Infant
Living Donors
Male
Metabolism, Inborn Errors
Middle Aged
Peripheral Blood Stem Cell Transplantation
Pregnancy
Pregnancy Complications, Neoplastic
Retrospective Studies
Transplantation, Homologous
jenkins-FCD Prod-296 4db9d02597e0a2e889e230f853b641c12f1c3ee3