Relationship of race/ethnicity and survival after single umbilical cord blood transplantation for adults and children with leukemia and myelodysplastic syndromes. Biol Blood Marrow Transplant 2012 Jun;18(6):903-12
Date
11/09/2011Pubmed ID
22062801Pubmed Central ID
PMC3874400DOI
10.1016/j.bbmt.2011.10.040Scopus ID
2-s2.0-84860838979 (requires institutional sign-in at Scopus site) 34 CitationsAbstract
The relationship of race/ethnicity with outcomes of umbilical cord blood transplantation (UCBT) is not well known. We analyzed the association between race/ethnicity and outcomes of unrelated single UCBT for leukemia and myelodysplastic syndromes. Our retrospective cohort study consisted of 885 adults and children (612 whites, 145 blacks, and 128 Hispanics) who received unrelated single UCBT for leukemia and myelodysplastic syndromes between 1995 and 2006 and were reported to the Center for International Blood and Marrow Transplant Research. A 5-6/6 HLA-matched unit with a total nucleated cell count infused of ≥2.5 × 10(7)/kg was given to 40% white and 42% Hispanic, but only 21% black patients. Overall survival at 2 years was 44% for whites, 34% for blacks, and 46% for Hispanics (P = .008). In multivariate analysis adjusting for patient, disease, and treatment factors (including HLA match and cell dose), blacks had inferior overall survival (relative risk of death, 1.31; P = .02), whereas overall survival of Hispanics was similar (relative risk, 1.03; P = .81) to that of whites. For all patients, younger age, early-stage disease, use of units with higher cell dose, and performance status ≥80 were independent predictors of improved survival. Black patients and white patients infused with well-matched cords had comparable survival; similarly, black and white patients receiving units with adequate cell dose had similar survival. These results suggest that blacks have inferior survival to whites after single UCBT, but outcomes are improved when units with a higher cell dose are used.
Author List
Ballen KK, Klein JP, Pedersen TL, Bhatla D, Duerst R, Kurtzberg J, Lazarus HM, LeMaistre CF, McCarthy P, Mehta P, Palmer J, Setterholm M, Wingard JR, Joffe S, Parsons SK, Switzer GE, Lee SJ, Rizzo JD, Majhail NSAuthor
J. Douglas Rizzo MD, MS Director, Center Associate Director, Professor in the Medicine department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
AdolescentAdult
Age Factors
Aged
Cell Count
Child
Child, Preschool
Cord Blood Stem Cell Transplantation
Disease-Free Survival
Female
Fetal Blood
HLA Antigens
Histocompatibility Testing
Humans
Infant
Leukemia
Male
Middle Aged
Myelodysplastic Syndromes
Retrospective Studies
Treatment Outcome
United States
