Race as a factor in donor selection and survival of children with hematologic malignancies undergoing hematopoietic stem cell transplant in Florida
| Autor: | John Fort, Jing Zhao, Paul Castillo, Jorge Galvez Silva, Gauri Sunkersett, Nikhil Lamba, Michael Joyce, Benjamin Oshrine, Deepak Chellapandian, Warren Alperstein, Edward Ziga, Biljana Horn |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
Graft vs Host Disease Human leukocyte antigen Gastroenterology Donor Selection 03 medical and health sciences 0302 clinical medicine HLA Antigens Internal medicine medicine Humans Child Cause of death Retrospective Studies Donor selection business.industry Incidence (epidemiology) Hematopoietic Stem Cell Transplantation Hematopoietic stem cell Hematology Race Factors medicine.anatomical_structure Oncology 030220 oncology & carcinogenesis Cord blood Relative risk Hematologic Neoplasms Pediatrics Perinatology and Child Health Cohort Florida business Unrelated Donors 030215 immunology |
| Zdroj: | Pediatric bloodcancerREFERENCES. 68(10) |
| ISSN: | 1545-5017 |
| Popis: | BACKGROUND Previous studies have explored posthematopoietic cell transplant (HCT) outcomes by race in adults; however, pediatric data addressing this topic are scarce. PROCEDURE This retrospective registry study included 238 White (W) and 57 Black (B) children with hematologic malignancies (HM) receiving first allogeneic HCT between 2010 and 2019 at one of the five Florida pediatric HCT centers. RESULTS We found no differences between W and B children in transplant characteristics, other than donor type. There was a significant difference in use of human leukocyte antigen (HLA)-mismatched donors (HLA-MMD) (53% W, 71% B, p = .01). When comparing HLA-MMD use to fully HLA-matched donors, B had relative risk (RR) of 1.47 (95% CI 0.7-3) of receiving a mismatched unrelated donor (MMUD), RR of 2.34 (95% CI 1.2-4.4) of receiving a mismatched related donor (MMRD), and RR of 1.9 (95% CI 0.99-3.6) of receiving a mismatched cord blood donor (MMCBD) HCT, respectively. There was no significant difference in the incidence of aGVHD (48% W, 35% B), p = .1, or cGVHD (19% W, 28% B, p = .1), or primary cause of death. Overall 24-month survival was 61% (95% CI 55%-68%) for W, and 60% (95% CI 48-75) for B children, log-rank p = .7. While HLA matching improved survival in W children, the number of B children receiving HLA-matched HCT was too small to identify the impact of HLA matching on survival. CONCLUSIONS In this contemporary cohort of children with HM, we found that B children were more likely to receive HLA-MMD transplants, but this did not adversely affect survival or GVHD rates. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Plný text