Bhagirathbhai Dholaria, MBBS, Associate Professor of Medicine and a hematopoietic cell transplantation specialist, along with peers from several other transplant centers across the country, recently reached a major milestone in stem cell transplantation.
Their clinical trial, called ACCESS, showed that using “mismatched donors” for blood or bone marrow transplants is safe, potentially opening the door to cures for blood cancers such as leukemia and lymphoma.
Findings from the ACCESS trial were recently published in the journal JAMA Network Open.
“Many patients need a donor whose tissue type closely matches their own,” Dholaria said. “Historically, patients from racial and ethnic minority groups have had a harder time finding a perfectly matched donor because donor registries included fewer people from their backgrounds.
“As a result, minority patients are referred less often or move more slowly toward transplant because finding a fully matched donor can be difficult. If doctors believe a suitable donor is unlikely, they may never see a transplant physician in the first place.”
Expanding access and opportunity at the same time
The ACCESS trial set out to dismantle this barrier by allowing mismatched, unrelated donors for patients lacking a full match. Typically, traditional clinical trials restrict enrollment to matched donors only.
By eliminating the requirement for a perfectly matched donor, ACCESS opened the door for more Asian, Black, Hispanic and multiracial patients who previously may not have been eligible for a transplant or clinical trial.
Nearly half of participants in this trial identified as members of racially or ethnically underrepresented groups.
Comparing nearly 670 patients across three different studies, Dholaria and colleagues found that ACCESS participants were more than 25 percentage points more likely to come from diverse racial and ethnic backgrounds than those enrolled in other trials. The broader eligibility criteria also expanded the pool of potential donors available to patients.
“The more we broaden access to transplant, the more patients we can give an opportunity for cure,” said Dholaria.
