title: Paucity of HLA-identical unrelated donors for African-Americans with hematologic malignancies: the need for new donor options.
abstract: Identification of an HLA identical donor/recipient pair using high-resolution techniques at HLA A, B, C, and DRB1 optimizes survival after adult unrelated hematopoietic stem cell transplant. It has been estimated that roughly 50% of African-Americans have suitable unrelated donors based on serologic typing, but there is little information on the likelihood of identifying an HLA-identical unrelated donor using molecular techniques. From February 2002 to May 2007, we performed 51 unrelated donor searches for African-American patients using the National Marrow Donor Program and found HLA identical unrelated donors for only 3. By contrast, 50 (98%) had at least 1, and often multiple, appropriately matched cord blood units available. Very few African-American recipients have HLA-identical unrelated donors. To allow more African-American patients to proceed to transplant, innovative donor strategies, including adult cord blood transplantation, haploidentical transplant, or the identification of permissive mismatches should be investigated.
authors.affiliation: Section of Hematology/Oncology, Department of Medicine, University of Chicago, Chicago, Illinois, USA.
authors.forename: Alexander
authors.initials: A
authors.lastname: Dew
authors.forename: Demetria
authors.initials: D
authors.lastname: Collins
authors.forename: Andrew
authors.initials: A
authors.lastname: Artz
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Rich
authors.forename: Wendy
authors.initials: W
authors.lastname: Stock
authors.forename: Kate
authors.initials: K
authors.lastname: Swanson
authors.forename: Koen
authors.initials: K
authors.lastname: van Besien
mesh_terms: D000293:Adolescent; D000328:Adult; D001741:Black or African American; D000368:Aged; D002648:Child; D002675:Child, Preschool; D006680:HLA Antigens; D019337:Hematologic Neoplasms / Q000628:therapy*; D018380:Hematopoietic Stem Cell Transplantation; D006648:Histocompatibility / Q000276:immunology*; D006801:Humans; D007223:Infant; D008875:Middle Aged; D012042:Registries; D014019:Tissue Donors / Q000706:statistics & numerical data / Q000600:supply & distribution*
chemical_list: D006680:HLA Antigens