Relationship of Race/Ethnicity and Survival after Single Umbilical Cord Blood Transplantation for Adults and Children with Leukemia and Myelodysplastic Syndromes

被引:36
作者
Ballen, Karen K. [1 ]
Klein, John P. [2 ]
Pedersen, Tanya L. [3 ]
Bhatla, Deepika [4 ]
Duerst, Reggie [5 ]
Kurtzberg, Joanne [6 ]
Lazarus, Hillard M. [7 ]
LeMaistre, Charles F. [8 ]
McCarthy, Phillip [9 ]
Mehta, Paulette [10 ]
Palmer, Jeanne [11 ]
Setterholm, Michelle [12 ]
Wingard, John R. [13 ]
Joffe, Steven [14 ]
Parsons, Susan K. [15 ]
Switzer, Galen E. [16 ]
Lee, Stephanie J. [17 ]
Rizzo, J. Douglas [2 ]
Majhail, Navneet S. [3 ,18 ]
机构
[1] Massachusetts Gen Hosp, Div Hematol Oncol, Boston, MA 02114 USA
[2] Med Coll Wisconsin, Ctr Int Blood & Marrow Transplant Res, Milwaukee, WI 53226 USA
[3] Ctr Int Blood & Marrow Transplant Res, Minneapolis, MN USA
[4] St Louis Univ, St Louis, MO 63103 USA
[5] Childrens Mem Hosp, Chicago, IL 60614 USA
[6] Duke Univ, Med Ctr, Durham, NC USA
[7] Univ Hosp Case Med Ctr, Cleveland, OH USA
[8] Texas Transplant Inst, San Antonio, TX USA
[9] Roswell Pk Canc Inst, Buffalo, NY 14263 USA
[10] Univ Arkansas, Little Rock, AR 72204 USA
[11] Childrens Hosp Wisconsin, Milwaukee, WI 53201 USA
[12] Natl Marrow Donor Program, Minneapolis, MN USA
[13] Univ Florida, Shands Canc Ctr, Gainesville, FL USA
[14] Dana Farber Canc Inst, Boston, MA 02115 USA
[15] Tufts Med Ctr, Boston, MA USA
[16] UPMC Hillman Canc Ctr, Pittsburgh, PA USA
[17] Fred Hutchinson Canc Res Ctr, Seattle, WA 98104 USA
[18] Univ Minnesota, Minneapolis, MN USA
关键词
Umbilical cord blood; Leukemia; Myelodysplastic syndrome; Race; Ethnicity; Transplantation; BONE-MARROW-TRANSPLANTATION; STEM-CELL TRANSPLANTATION; VERSUS-HOST-DISEASE; INTERNATIONAL BLOOD; UNRELATED DONORS; OUTCOMES; REGISTRY;
D O I
10.1016/j.bbmt.2011.10.040
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
The relationship of race/ethnicity with outcomes of umbilical cord blood transplantation (UCBT) is not well known. We analyzed the association between race/ethnicity and outcomes of unrelated single UCBT for leukemia and myelodysplastic syndromes. Our retrospective cohort study consisted of 885 adults and children (6 I 2 whites, 145 blacks, and 128 Hispanics) who received unrelated single UCBT for leukemia and myelodysplastic syndromes between 1995 and 2006 and were reported to the Center for International Blood and Marrow Transplant Research. A 5-6/6 FILA-matched unit with a total nucleated cell count infused of >= 2.5 x 10(7)/kg was given to 40% white and 42% Hispanic, but only 21% black patients. Overall survival at 2 years was 44%. for whites, 34% for blacks, and 46% for Hispanics (P = .008). In multivariate analysis adjusting for patient, disease, and treatment factors (including HLA match and cell dose), blacks had inferior overall survival (relative risk of death, 1.31; P = .02), whereas overall survival of Hispanics was similar (relative risk, 1.03; P = .81) to that of whites. For all patients, younger age, early-stage disease, use of units with higher cell dose, and performance status >= 80 were independent predictors of improved survival. Black patients and white patients infused with well-matched cords had comparable survival; similarly, black and white patients receiving units with adequate cell dose had similar survival. These results suggest that blacks have inferior survival to whites after single UCBT, but outcomes are improved when units with a higher cell dose are used. Biol Blood Marrow Transplant 18: 903-912 (2012) (C) 2012 American Society for Blood and Marrow Transplantation
引用
收藏
页码:903 / 912
页数:10
相关论文
共 31 条
[21]   Assessment of optimal size and composition of the US National Registry of Hematopoietic Stem Cell Donors [J].
Kollman, C ;
Abella, E ;
Baitty, RL ;
Beatty, PG ;
Chakraborty, R ;
Christiansen, CL ;
Hartzman, RJ ;
Hurley, CK ;
Milford, E ;
Nyman, JA ;
Smith, TJ ;
Switzer, GE ;
Wada, RK ;
Setterholm, M .
TRANSPLANTATION, 2004, 78 (01) :89-95
[22]   Outcomes after transplantation of cord blood or bone marrow from unrelated donors in adults with leukemia [J].
Laughlin, MJ ;
Eapen, M ;
Rubinstein, P ;
Wagner, JE ;
Zhang, MJ ;
Champlin, RE ;
Stevens, C ;
Barker, JN ;
Gale, RP ;
Lazarus, HM ;
Marks, DI ;
van Rood, JJ ;
Scaradavou, A ;
Horowitz, MM .
NEW ENGLAND JOURNAL OF MEDICINE, 2004, 351 (22) :2265-2275
[23]   Proportionally more deleterious genetic variation in European than in African populations [J].
Lohmueller, Kirk E. ;
Indap, Amit R. ;
Schmidt, Steffen ;
Boyko, Adam R. ;
Hernandez, Ryan D. ;
Hubisz, Melissa J. ;
Sninsky, John J. ;
White, Thomas J. ;
Sunyaev, Shamil R. ;
Nielsen, Rasmus ;
Clark, Andrew G. ;
Bustamante, Carlos D. .
NATURE, 2008, 451 (7181) :994-U5
[24]   Access to Hematopoietic Cell Transplantation in the United States [J].
Majhail, Navneet S. ;
Omondi, Nancy A. ;
Denzen, Ellen ;
Murphy, Elizabeth A. ;
Rizzo, J. Douglas .
BIOLOGY OF BLOOD AND MARROW TRANSPLANTATION, 2010, 16 (08) :1070-1075
[25]   Effects of race on survival after stem cell transplantation [J].
Mielcarek, M ;
Gooley, T ;
Martin, P ;
Chauncey, TR ;
Young, BA ;
Storb, R ;
Torok-Storb, B .
BIOLOGY OF BLOOD AND MARROW TRANSPLANTATION, 2005, 11 (03) :231-239
[26]   Comparison of graft-versus-host-disease and survival after HLA-identical sibling bone marrow transplantation in ethnic populations [J].
Oh, H ;
Loberiza, FR ;
Zhang, MJ ;
Ringdén, O ;
Akiyama, H ;
Asai, T ;
Miyawaki, S ;
Okamoto, S ;
Horowitz, MM ;
Antin, JH ;
Bashey, A ;
Bird, JM ;
Carabasi, MH ;
Fay, JW ;
Gale, RP ;
Giller, RH ;
Goldman, JM ;
Hale, GA ;
Harris, RE ;
Henslee-Downey, J ;
Kolb, HJ ;
Litzow, MR ;
McCarthy, PL ;
Neudorf, SM ;
Serna, DS ;
Socié, G ;
Tiberghien, P ;
Barrett, AJ .
BLOOD, 2005, 105 (04) :1408-1416
[27]  
PRZEPIORKA D, 1995, BONE MARROW TRANSPL, V15, P825
[28]   The graft-versus-leukemia effect using matched unrelated donors is not superior to HLA-identical siblings for hematopoietic stem cell transplantation [J].
Ringden, Olle ;
Pavletic, Steven Z. ;
Anasetti, Claudio ;
Barrett, A. John ;
Wang, Tao ;
Wang, Dan ;
Antin, Joseph H. ;
Di Bartolomeo, Paolo ;
Bolwell, Brian J. ;
Bredeson, Christopher ;
Cairo, Mitchell S. ;
Gale, Robert P. ;
Gupta, Vikas ;
Hahn, Theresa ;
Hale, Gregory A. ;
Halter, Jorg ;
Jagasia, Madan ;
Litzow, Mark R. ;
Locatelli, Franco ;
Marks, David I. ;
McCarthy, Philip L. ;
Cowan, Morton J. ;
Petersdorf, Effie W. ;
Russell, James A. ;
Schiller, Gary J. ;
Schouten, Harry ;
Spellman, Stephen ;
Verdonck, Leo F. ;
Wingard, John R. ;
Horowitz, Mary M. ;
Arora, Mukta .
BLOOD, 2009, 113 (13) :3110-3118
[29]   Trends in survival rates after allogeneic hematopoietic stem-cell transplantation for acute and chronic leukemia by ethnicity in the United States and Canada [J].
Serna, DS ;
Lee, SJ ;
Zhang, MJ ;
Baker, KS ;
Eapen, M ;
Horowitz, MM ;
Klein, JP ;
Rizzo, JD ;
Loberiza, FR .
JOURNAL OF CLINICAL ONCOLOGY, 2003, 21 (20) :3754-3760
[30]  
SULLIVAN KM, 1991, SEMIN HEMATOL, V28, P250