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Transplant rates improved among ethnic minorities
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NEW ORLEANS — The likelihood that ethnic minorities who do not have a sibling donor can undergo stem cell transplantation has improved substantially in recent years, according to study results presented at the ASH Annual Meeting and Exposition.
In fact, the majority of patients who were not of white Northern European descent were able to find a 9/10 or 10/10 matched donor, and many of those who could not had the opportunity to undergo a cord blood or haploidentical donor transplant in a similar timeframe, according to researchers.
Robert N. Lown
“We celebrate the improvement in the number of ethnic minority patients reaching transplant over recent years, which reflect a significant increase in unrelated donor numbers worldwide, as well as expansion of the use of alternative stem cell sources such as cord blood and haploidentical relatives,” Robert N. Lown, MD, of the UK donor registry Anthony Nolan and UCL Cancer Institute in London, told HemOnc Today. “But there is still some way to go: we still don't know if outcomes with cord blood or haploidentical donor transplants are as good as unrelated donors, and ethnic minorities still remain disproportionately under-represented on international registries.”
In 2000, only 30% of ethnic minority patients without sibling donors were able to find a donor, according to background information provided by researchers.
In the current study, however, Lown and colleagues found the rate for transplantation in ethnic minorities was higher than in historical literature.
The researchers evaluated data from 332 patients referred to the Anthony Nolan Graft Identification and Advisory Service for identification of an unrelated adult donor or cord blood unit.
The cohort included 248 patients (74.7%) who were of white Northern European descent and 84 (25.3%) who were not.
Lown and colleagues determined a higher percentage of patients of Northern European descent found a 10/10 HLA-matched donor (69.3% vs. 20.5%; P˂.001) or at least a 9/10 HLA-matched donor (96.3% vs. 61.4%; P˂.001) at confirmatory typing than those not of Northern European descent.
“There is huge variation in tissue types within a population and certainly between populations, and this makes it difficult to find donor matches,” Lown said during a press conference. “This difference is particularly marked in people of different ethnicities. Even today, donors listed on registries tend to be of white Northern European descent, which disproportionately favors patients of the same ethnic background.”
More non-Northern European patients in the study received cord blood transplants (21.3% vs. 3.8%; P˂.001) and haploidentical transplants (10.6% vs. 1.3%; P˂.001).
However, when considering all graft sources, researchers reported no significant differences in the percentage of patients who reached transplant (63.3% of Northern European vs. 56% of non-Northern European; P=.185).
Researchers reported non-Northern European patients experienced a significantly longer time from confirmatory typing to identification of an unrelated donor (median 33.5 days vs. 27 days; P=.02), as well as a significantly longer time from search request to transplant of any graft source (median 132 days vs. 110 days; P=.03).
When researchers analyzed cumulative incidence of transplantation with death, they observed no significant difference between groups (P=.185).
Researchers reported a longer median time from search request to transplant for patients who underwent cord blood transplantation (median, 143 days; n=16) than for those who underwent transplantation from unrelated donors (median, 120.5 days; n=179) or haploidentical donors (91 days; n=6), although these differences were not statistically significant.
For more information:
Lown RN. Abstract #2138. Presented at: ASH Annual Meeting and Exposition; Dec. 7-10; New Orleans.
Disclosure: The researchers report no relevant financial disclosures.