NEW ORLEANS – The gap appears to be narrowing between white European patients and European patients of other ethnicities regarding times to stem cell transplant and ability to find a matched donor, based on a study conducted in the United Kingdom.
In the study, non-white northern European patients were less likely than white northern European patients to have a fully-matched donor available. Transplant was ultimately achieved by 62% of white and 56% of nonwhite patients in a four-center study of 332 leukemia and lymphoma patients treated in the United Kingdom in concert with Anthony Nolan, the United Kingdom’s blood cancer charity and bone marrow register. Non-white patients comprised 25% of the patient population, Dr. Robert Lown reported during a press conference held at the annual meeting of the American Society of Hematology.
"The use of cord blood and haploidentical transplants is ‘leveling the playing field’ for non-white patients seeking transplants other than with an HLA-identical sibling," said Dr. Lown of the Royal Marsden Hospital, London, and of Anthony Nolan.
Just 20% of non-white patients in the study had a fully-matched donor available, while 69% of white northern European patients did. A suitable donor was identified, however, for 96% of the white European patients and 61% of patients of other ethnicities. Ultimately, transplant was achieved by 62% of white and 56% of other ethnicity patients. Average time to transplant was 110 days for white patients and 132 days for patients of other ethnicities, he said.
The results reflect improvements since a Dutch study of patients treated from 1996-2000 found that 32% of nonwhite and 59% of white northern Europeans achieved transplants. Typically, those patients who could not find a donor were either not transplanted or used less suitable donors, an option associated with more complications and poorer prognosis, he said.
The number of donors listed in registries has expanded, and new sources of stem cells, like cord blood and haploidentical transplantation, are available, Dr. Lown said. Few studies before this one have examined how these changes have affected the ability of transplant centers to get patients to transplant.
The trial results may not reflect general clinical experience, however, Dr. Lown said. Anthony Nolan uses an expert graft identification and advisory service to optimize donor selection and determine which patients are unlikely to find suitable donors. This practice allows timely use of cord blood and haploidentical transplants, Dr. Lown said.
The Anthony Nolan Research Institute sponsored the study. Dr. Lown did not disclose any financial conflicts of interest.