Ethnically mismatched cord blood transplants in African Americans: the Saint Louis Cord Blood Bank experience.
BACKGROUND
For ethnic minority patients where a suitably matched BM or peripheral blood donor is frequently unavailable, cord blood offers an opportunity for hematopoietic stem cell transplantation. Focused recruitment of ethnic minorities for cord blood donation has been proposed as the preferred strategy to improve access for minority recipients to cord blood for transplantation. The aim of this study was to evaluate cord blood characteristics for Caucasian and African American donors and the success of ethnically mismatched UC blood transplantation in African American recipients.


METHODS
Retrospective data analysis was performed comparing the characteristics of 556 cord blood units from African American and Caucasian donors. The outcomes of 18 African American ethnically mismatched transplant recipients were compared with a paired sample of 18 ethnically matched Caucasian recipients.


RESULTS
The fraction of collected units meeting acceptability criteria from African Americans was significantly lower compared with Caucasians (P = <0.0001). Additionally, African Americans had a significantly lower post-processing total nucleated cell count (TNC) compared with Caucasians (P=0.007) but there were no other significant differences in conventionally measured product characteristics. In the transplant analysis, there was no difference in overall survival at 1 year (P=0.85) or time to neutrophil engraftment (P=0.92) between the two patient populations.


CONCLUSIONS
At comparable levels of TNC dose and HLA matching, the use of ethnically mismatched UC blood units as a source for allogeneic unrelated transplant can result in successful transplant outcomes for African American patients.
Wofford
J
J
Saint Louis Cord Blood Bank at SSM Cardinal Glennon Children's Medical Center, St Louis, MO 63110, USA. jwofford@slcbb.org
Kemp
J
J
Regan
D
D
Creer
M
M
D001741:Black or African American; D001771:Blood Banks; D001782:Blood Donors; D036101:Cord Blood Stem Cell Transplantation / Q000208:ethnology* / Q000401:mortality / Q000706:statistics & numerical data; D005312:Fetal Blood / Q000166:cytology; D006086:Graft vs Host Disease / Q000453:epidemiology; D018380:Hematopoietic Stem Cell Transplantation / Q000208:ethnology* / Q000379:methods / Q000401:mortality / Q000706:statistics & numerical data; D006801:Humans; D007231:Infant, Newborn; D007938:Leukemia / Q000628:therapy; D012189:Retrospective Studies; D016019:Survival Analysis; D044465:White People