TY - JOUR
T1 - Optimal Donor for African Americans with Hematologic Malignancy
T2 - HLA-Haploidentical Relative or Umbilical Cord Blood Transplant
AU - Solomon, Scott R.
AU - Martin, Andrew St
AU - Zhang, Mei Jie
AU - Ballen, Karen
AU - Bashey, Asad
AU - Battiwalla, Minoo
AU - Baxter-Lowe, Lee Ann
AU - Brunstein, Claudio
AU - Chhabra, Saurabh
AU - Perez, Miguel Angel Diaz
AU - Fuchs, Ephraim J.
AU - Ganguly, Siddhartha
AU - Hardy, Nancy
AU - Hematti, Peiman
AU - McGuirk, Joseph
AU - Peres, Edward
AU - Ringden, Olle
AU - Rizzieri, David
AU - Romee, Rizwan
AU - Solh, Melhem
AU - Szwajcer, David
AU - van der Poel, Marjolein
AU - Waller, Edmund
AU - William, Basem M.
AU - Eapen, Mary
N1 - Publisher Copyright:
© 2020 American Society for Transplantation and Cellular Therapy
PY - 2020/10
Y1 - 2020/10
N2 - 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.
AB - 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.
KW - African American
KW - Alternative donor
KW - Caucasian
KW - leukemia
KW - race
KW - transplant-related mortality
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UR - http://www.scopus.com/inward/citedby.url?scp=85089075393&partnerID=8YFLogxK
U2 - 10.1016/j.bbmt.2020.06.029
DO - 10.1016/j.bbmt.2020.06.029
M3 - Article
C2 - 32649981
AN - SCOPUS:85089075393
SN - 1083-8791
VL - 26
SP - 1930
EP - 1936
JO - Biology of Blood and Marrow Transplantation
JF - Biology of Blood and Marrow Transplantation
IS - 10
ER -