LAUSR

Accurate patient ancestry determination is critical in the evaluation of candidates for allogeneic bone marrow transplantation (BMT) without suitable related donors, given that patients with non-European ancestry are much less likely to have an 8 of 8 HLA – matched unrelated donor (URD) 1-4 and are more likely to suffer delays to transplant 5 which can adversely affect transplant outcomes. 6,7 It is known that recording patients with full or part non-European origins as White non-Hispanic can result in inaccurate and potentially dangerous overestimation of the likelihood of securing an 8 of 8 URD, thereby delaying pursuit of alternative – mismatched adult donors or cord blood grafts. To speed provision of allografts, our Center has developed a search prognosis tool that permits immediate estimation of the likelihood of securing an 8 of 8 URD in patients without an HLA-identical sibling. 8,9 However, the tool ’ s accuracy is greatly in fl uenced by the knowledge regarding a patient ’ s European or non-European origin. 8,9 For these reasons, our BMT Program staff evaluated ancestry in all allograft candidates without HLA – identical sibling donors. The relevance of ancestry in donor searches is explained fi rst, and then a kinship history is recorded including the patient ’ s country of origin, that of their maternal/paternal ancestors, and the patient ’ s consideration of themself as Black and/or Hispanic. Ancestry is then classi fi ed as European, African (including African American, Afro-Caribbean, and African immigrants), White Hispanic (including patients of Central/South American origin who self-identi fi ed as non-Black and