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

Karen K. Ballen, John P. Klein, Tanya L. Pedersen, Deepika Bhatla, Reggie Duerst, Joanne Kurtzberg, Hillard M. Lazarus, Charles F. LeMaistre, Phillip McCarthy, Paulette Mehta, Jeanne Palmer, Michelle Setterholm, John R. Wingard, Steven Joffe, Susan K. Parsons, Galen E. Switzer, Stephanie J. Lee, J. Douglas Rizzo, Navneet S. Majhail

Research output: Contribution to journalArticle

24 Citations (Scopus)

Abstract

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 (612 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 HLA-matched unit with a total nucleated cell count infused of ≥2.5 × 107/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.

Original languageEnglish (US)
Pages (from-to)903-912
Number of pages10
JournalBiology of Blood and Marrow Transplantation
Volume18
Issue number6
DOIs
StatePublished - Jun 1 2012
Externally publishedYes

Fingerprint

Myelodysplastic Syndromes
Fetal Blood
Leukemia
Transplantation
Survival
Hispanic Americans
Cohort Studies
Multivariate Analysis
Retrospective Studies
Cell Count
Bone Marrow
Transplants
hydroquinone
Research

Keywords

  • Ethnicity
  • Leukemia
  • Myelodysplastic syndrome
  • Race
  • Transplantation
  • Umbilical cord blood

ASJC Scopus subject areas

  • Hematology
  • Transplantation

Cite this

Relationship of Race/Ethnicity and Survival after Single Umbilical Cord Blood Transplantation for Adults and Children with Leukemia and Myelodysplastic Syndromes. / Ballen, Karen K.; Klein, John P.; Pedersen, Tanya L.; Bhatla, Deepika; Duerst, Reggie; Kurtzberg, Joanne; Lazarus, Hillard M.; LeMaistre, Charles F.; McCarthy, Phillip; Mehta, Paulette; Palmer, Jeanne; Setterholm, Michelle; Wingard, John R.; Joffe, Steven; Parsons, Susan K.; Switzer, Galen E.; Lee, Stephanie J.; Rizzo, J. Douglas; Majhail, Navneet S.

In: Biology of Blood and Marrow Transplantation, Vol. 18, No. 6, 01.06.2012, p. 903-912.

Research output: Contribution to journalArticle

Ballen, KK, Klein, JP, Pedersen, TL, Bhatla, D, Duerst, R, Kurtzberg, J, Lazarus, HM, LeMaistre, CF, McCarthy, P, Mehta, P, Palmer, J, Setterholm, M, Wingard, JR, Joffe, S, Parsons, SK, Switzer, GE, Lee, SJ, Rizzo, JD & Majhail, NS 2012, 'Relationship of Race/Ethnicity and Survival after Single Umbilical Cord Blood Transplantation for Adults and Children with Leukemia and Myelodysplastic Syndromes', Biology of Blood and Marrow Transplantation, vol. 18, no. 6, pp. 903-912. https://doi.org/10.1016/j.bbmt.2011.10.040
Ballen, Karen K. ; Klein, John P. ; Pedersen, Tanya L. ; Bhatla, Deepika ; Duerst, Reggie ; Kurtzberg, Joanne ; Lazarus, Hillard M. ; LeMaistre, Charles F. ; McCarthy, Phillip ; Mehta, Paulette ; Palmer, Jeanne ; Setterholm, Michelle ; Wingard, John R. ; Joffe, Steven ; Parsons, Susan K. ; Switzer, Galen E. ; Lee, Stephanie J. ; Rizzo, J. Douglas ; Majhail, Navneet S. / Relationship of Race/Ethnicity and Survival after Single Umbilical Cord Blood Transplantation for Adults and Children with Leukemia and Myelodysplastic Syndromes. In: Biology of Blood and Marrow Transplantation. 2012 ; Vol. 18, No. 6. pp. 903-912.
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