Reducing ethnic disparity in access to high-quality HLA-matched cord blood units for transplantation: analysis of the Canadian Blood Services' Cord Blood Bank inventory.

Authors:
David Allan
David Allan
University of Ottawa
Canada
Jeffrey Kiernan
Jeffrey Kiernan
University of Ottawa
Ottawa | Canada
Loren Gragert
Loren Gragert
University of California
United States
Daniel Bartlett
Daniel Bartlett
Florida State University
Tallahassee | United States
Todd Campbell
Todd Campbell
University of Tampa
Karen Mostert
Karen Mostert
Canadian Blood Services' Cord Blood Bank
Michael Halpenny
Michael Halpenny
Sigma-Aldrich

Transfusion 2019 Apr 19. Epub 2019 Apr 19.

Canadian Blood Services' Cord Blood Bank, Ottawa, Ontario.

Background: Launched in 2013, Canadian Blood Services' Cord Blood Bank (CBS' CBB) has built a high-quality, ethnically diverse cord blood repository that aims to reduce ethnic disparity in accessing suitable units for transplantation.

Methods And Results: As of December 2016, 2000 units have been banked. The self-reported maternal ethnicity was 58% non-Caucasian. Overall, 26% of units were classified as multi-ethnicity with Caucasian (84%) most frequently observed in combination with Asian, First Nations (predominant indigenous peoples in Canada south of the Arctic Circle), or African ethnicity. Utilization scores that incorporate total nucleated and CD34+ cell counts in the CBS' CBB were associated with greater likelihood of utilization compared with the international inventory of units (p < 0.05). The distribution of utilization scores was similar for Caucasians compared with non-Caucasians (p < 0.05). Using HLA genotypes of cord blood units and their mothers, we determined probable ethnic assignments for each haplotype using HaploStats (National Marrow Donor Program). Significant increases in HLA-match likelihoods are predicted for all ethnicities as the inventory grows to its target of 10,000 units and the gap in HLA-match likelihoods for Caucasian and non-Caucasian patients progressively declines.

Conclusions: The CBS' CBB inventory is predicted to have high HLA-matching likelihoods across a broad spectrum of ethnic groups, improving access to high-quality stem cell products for all patients.

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Source
http://dx.doi.org/10.1111/trf.15313DOI Listing
April 2019

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