Paucity of HLA-Identical Unrelated Donors for African-Americans with Hematologic Malignancies: The Need for New Donor Options

Abstract Identification of an HLA identical donor/recipient pair using high-resolution techniques at HLA A, B, C, and DRB1 optimizes survival after adult unrelated hematopoietic stem cell transplant. It has been estimated that roughly 50% of African-Americans have suitable unrelated donors based on...

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Bibliographic Details
Published in:Biology of blood and marrow transplantation 2008-08, Vol.14 (8), p.938-941
Main Authors: Dew, Alexander, Collins, Demetria, Artz, Andrew, Rich, Elizabeth, Stock, Wendy, Swanson, Kate, van Besien, Koen
Format: Article
Language:English
Subjects:
Adolescent
Adult
African Americans
African-American
Aged
Child
Child, Preschool
Cord blood
Hematologic Neoplasms - therapy
Hematology, Oncology and Palliative Medicine
Hematopoietic Stem Cell Transplantation
Histocompatibility - immunology
HLA Antigens
Humans
Infant
Middle Aged
Registries
Tissue Donors - statistics & numerical data
Tissue Donors - supply & distribution
Unrelated donor
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Summary:Abstract Identification of an HLA identical donor/recipient pair using high-resolution techniques at HLA A, B, C, and DRB1 optimizes survival after adult unrelated hematopoietic stem cell transplant. It has been estimated that roughly 50% of African-Americans have suitable unrelated donors based on serologic typing, but there is little information on the likelihood of identifying an HLA-identical unrelated donor using molecular techniques. From February 2002 to May 2007, we performed 51 unrelated donor searches for African-American patients using the National Marrow Donor Program® and found HLA identical unrelated donors for only 3. By contrast, 50 (98%) had at least 1, and often multiple, appropriately matched cord blood units available. Very few African-American recipients have HLA-identical unrelated donors. To allow more African-American patients to proceed to transplant, innovative donor strategies, including adult cord blood transplantation, haploidentical transplant, or the identification of permissive mismatches should be investigated.
ISSN:1083-8791
1523-6536
DOI:10.1016/j.bbmt.2008.06.005