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Extended family studies for the identification of allogeneic stem cell transplant donors in Jewish and Arabic patients in Israel
Author(s) -
Klein T.,
Yaniv I.,
Stein J.,
Narinsky R.,
Finkelstein Y.,
Garty B. Z.
Publication year - 2005
Publication title -
pediatric transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.457
H-Index - 69
eISSN - 1399-3046
pISSN - 1397-3142
DOI - 10.1111/j.1399-3046.2004.00222.x
Subject(s) - medicine , judaism , arabic , population , demography , odds ratio , theology , philosophy , linguistics , environmental health , sociology
HLA‐identified donors are the best source of allogeneic hematopoietic stem cell transplants, and are available in approximately 40% of cases. If no HLA‐identical core family member is found, an extended family search may be performed. The aim of the study was to summarize the 10‐year (1990–1999) experience of our tertiary care center with extended family donor search. During this period, 356 patients and 2659 of their family members were tissue‐typed; 239 patients were Jewish (67%) and 117 were Arabic (33%). An HLA‐identical core‐family donor was identified for 168 patients (47%): 95 Jewish (40%) and 73 Arabic (62%) (p < 0.0001); 49 patients (14%) had more than one potential donor. An extended family search (grandmother/grandfather, aunts, uncles, etc.) was performed in 38 of the remaining families, which were found to be consanguineous: five Jewish and 33 Arabic. One HLA match was found in the Jewish families (20%) and 21 in the Arabic families (64%). The odds ratio for an Arabic patient to find a donor in the extended family search was 8.75, as opposed to a Jewish patient. Overall, HLA‐matched donors were found by core and extended family search for 53% of the patients. The rate for Arabic patients was 80% and for Jewish patients, 40% (p < 0.001). This difference may be explained by the greater number of siblings and higher rate of consanguinity in the Arabic population. In conclusion, an extended family search for potential HLA‐matched donors is worthwhile, especially in distinct ethnic populations with high consanguinity, such as Israeli Arabs.