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Histocompatibility and Donor Selection

Race/ethnicity affects the probability of finding an HLA-A, -B, -C and -DRB1 allele-matched unrelated donor and likelihood of subsequent transplant utilization

Bone Marrow Transplantation volume 48, pages 346–350 (2013)Cite this article

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Abstract

Factors relevant to finding a suitable unrelated donor and barriers to effective transplant utilization are incompletely understood. Among a consecutive series of unrelated searches (n=531), an 8/8 HLA-A, -B, -C and -DRB1-matched unrelated donor was available for 289 (54%) patients, 7/8 for 159 (30%) and no donor for 83 (16%). Patients of Caucasian race (P<0.0001) were more likely to find a donor. Younger age (P=0.01), Caucasian race (P=0.03), lower CIBMTR (Center for International Blood and Marrow Transplantation Research) risk (P=0.005), and 8/8 HLA matching (P=0.005) were associated with higher odds of reaching hematopoietic cell transplantation (HCT). In a univariate analysis of OS, finding a donor was associated with hazard ratio (HR) of 0.85 (95% CI 0.63–1.2), P=0.31. Karnofsky performance status (KPS) accounted for interaction between having a donor and survival. Patients with KPS 90–100 and a donor had significantly reduced hazard for death (HR 0.59, 95% CI 0.38–0.90, P=0.02). These data provide estimates of the probability to find an unrelated donor in the era of high-resolution HLA typing, and identify potentially modifiable barriers to reaching HCT. Further efforts are needed to enhance effective donor identification and transplant utilization, particularly in non-Caucasian ethnic groups.

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Authors and Affiliations

  1. Blood and Marrow Transplantation, Moffitt Cancer Center, Tampa, FL, USA

    J Pidala, R Hillgruber, V Nye, E Ayala, M Alsina, B Betts, R Bookout, H F Fernandez, T Field, F L Locke, T Nishihori, J L Ochoa, L Perez, J Perkins, J Shapiro, C Tate, M Tomblyn & C Anasetti

  2. Oncologic Sciences, University of South Florida, Tampa, FL, USA

    J Pidala, J Kim, M Schell, E Ayala, M Alsina, B Betts, R Bookout, H F Fernandez, T Field, F L Locke, T Nishihori, J L Ochoa, L Perez, J Perkins, J Shapiro, C Tate, M Tomblyn & C Anasetti

  3. Biostatistics, Moffitt Cancer Center, Tampa, FL, USA

    J Kim & M Schell

  4. Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA

    S J Lee

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  1. J Pidala
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Correspondence to J Pidala.

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Pidala, J., Kim, J., Schell, M. et al. Race/ethnicity affects the probability of finding an HLA-A, -B, -C and -DRB1 allele-matched unrelated donor and likelihood of subsequent transplant utilization. Bone Marrow Transplant 48, 346–350 (2013). https://doi.org/10.1038/bmt.2012.150

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