Faculty Collaboration Database

Optimal Donor for African Americans with Hematologic Malignancy: HLA-Haploidentical Relative or Umbilical Cord Blood Transplant. Biol Blood Marrow Transplant 2020 Oct;26(10):1930-1936

Date

07/11/2020

Pubmed ID

32649981

Pubmed Central ID

PMC7530013

DOI

10.1016/j.bbmt.2020.06.029

Scopus ID

2-s2.0-85089075393 (requires institutional sign-in at Scopus site)   10 Citations

Abstract

Although hematopoietic cell transplantation from an HLA-matched unrelated donor is potentially curative for hematologic malignancies, survival is lower for African Americans compared with Caucasians. Because only approximately 20% of African Americans will have an HLA-matched unrelated donor, many of these patients undergo HLA-haploidentical relative or umbilical cord blood transplantation. In this study, we analyzed outcomes after HLA-haploidentical related donor (n = 249) and umbilical cord blood (n = 118) transplantations in African American patients with hematologic malignancy between 2008 and 2016. The predominant disease was acute myelogenous leukemia for recipients of both types of donor grafts. The incidences of grade II-IV and III-IV acute graft-versus-host disease were higher after umbilical cord blood transplantation compared with HLA-haploidentical relative transplantation (56% and 29%, respectively, versus 33% and 11%, respectively; P < .0001). The 2-year incidence of transplantation-related mortality adjusted for age and conditioning regimen intensity was higher after umbilical cord blood transplantation compared with HLA-haploidentical related donor transplantation (31% versus 18%; P = .008); however, there were no between-group differences in the 2-year adjusted incidence of relapse (30% versus 34%; P = .51), overall survival (54% versus 57%; P = .66), or disease-free survival (43% versus 47%; P = .46). Our findings show that the use of HLA-haploidentical and umbilical cord blood transplants expands the access to transplantation with comparable leukemia-free and overall survival for African Americans with hematologic malignancies.

Author List

Solomon SR, Martin AS, Zhang MJ, Ballen K, Bashey A, Battiwalla M, Baxter-Lowe LA, Brunstein C, Chhabra S, Perez MAD, Fuchs EJ, Ganguly S, Hardy N, Hematti P, McGuirk J, Peres E, Ringden O, Rizzieri D, Romee R, Solh M, Szwajcer D, van der Poel M, Waller E, William BM, Eapen M

Authors

Mary Eapen MBBS, DCh, MRCPI, MS Professor in the Medicine department at Medical College of Wisconsin
Peiman Hematti MD Professor in the Medicine department at Medical College of Wisconsin
Mei-Jie Zhang PhD Professor in the Institute for Health and Equity department at Medical College of Wisconsin

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

Cord Blood Stem Cell Transplantation
Fetal Blood
Graft vs Host Disease
Hematologic Neoplasms
Hematopoietic Stem Cell Transplantation
Histocompatibility Testing
Humans