Race as a factor in donor selection and survival of children with hematologic malignancies undergoing hematopoietic stem cell transplant in Florida

Biljana Horn, Nikhil Lamba, Deepak Chellapandian, Gauri Sunkersett, Jorge Galvez Silva, Edward Ziga, Warren Alperstein, Michael Joyce, Paul Castillo, John Fort, Jing Zhao, Benjamin Oshrine

Research output: Contribution to journalArticlepeer-review

Abstract

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.

Original languageEnglish (US)
Article numbere29180
JournalPediatric Blood and Cancer
Volume68
Issue number10
DOIs
StatePublished - Oct 2021

Keywords

  • Florida consortium
  • malignant disorders
  • pediatric HCT
  • race disparities

ASJC Scopus subject areas

  • Hematology
  • Oncology
  • Pediatrics, Perinatology, and Child Health

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