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Race as a Factor in Donor Selection and Survival of Children with Hematologic Malignancies Undergoing Hematopoietic Stem Cell Transplant in Florida
  • +9
  • Biljana Horn,
  • Deepak Chellapandian,
  • Nikhil Lamba,
  • Gauri Sunkersett,
  • Jorge GalvezSilva,
  • Edward Ziga,
  • Warren Alperstein,
  • Micahel Joyce,
  • Paul Castillo,
  • John Fort,
  • Jing Zhao,
  • Benjamin Oshrine
Biljana Horn
University of Florida
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Deepak Chellapandian
Johns Hopkins All Children's Hospital
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Nikhil Lamba
University of Florida
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Gauri Sunkersett
Johns Hopkins All Children's Hospital
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Jorge GalvezSilva
Nicklaus Children's Hospital
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Edward Ziga
University of Miami Miller School of Medicine
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Warren Alperstein
University of Miami Miller School of Medicine
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Micahel Joyce
Nemours Children's Health System
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Paul Castillo
University of Florida
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John Fort
University of Florida
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Jing Zhao
University of Florida
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Benjamin Oshrine
Johns Hopkins All Children's Hospital
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Abstract

Background Previous studies have explored post-hematopoietic 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 in one of five Florida pediatric HCT centers. Results We found no differences between W and B children by transplant characteristics, other than donor type. There was a significant difference in use of HLA-mismatched donors (HLA-MMD) (53% W, 71% B, p=0.01). When comparing HLA-MMD use to fully HLA-matched donors, B had 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 a 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=0.1 or cGVHD (19% W 28% B, p=0.1), or primary cause of death. Overall 24-month survival was 61% [95% CI 54-68%] for W, and 60% [95% CI 38-68] for B children, log-rank p=0.72. 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.

Peer review status:ACCEPTED

01 Apr 2021Submission Checks Completed
01 Apr 2021Assigned to Editor
01 Apr 2021Submitted to Pediatric Blood & Cancer
09 Apr 2021Reviewer(s) Assigned
29 Apr 2021Review(s) Completed, Editorial Evaluation Pending
01 May 2021Editorial Decision: Revise Major
12 May 2021Submission Checks Completed
12 May 2021Assigned to Editor
12 May 20211st Revision Received
13 May 2021Reviewer(s) Assigned
24 May 2021Review(s) Completed, Editorial Evaluation Pending
25 May 2021Editorial Decision: Accept