Abstract
Abstract Much attention has been given to the plight of minorities and persons of mixed race in need of a bone marrow transplant. This has led to increased efforts to recruit minority and mixed-race donors. There is strong evidence that members of racial minorities are less likely to find a match than those of European descent. Because the relevant sample sizes are small, direct estimation of the distribution of immunity types for mixed-race populations have not been available. We show how to estimate the distribution of HLA types for persons of mixed race indirectly, using simple principles of probability and the combinatorics of diploid reproduction. We show that recruitment of mixed race donors is cost-effective, but not for the expected reasons. While recruitment of mixed-race donors increases the welfare of patients with the same racial background, the benefits to the targeted recipients do not exceed the costs. However, when account is taken of the likelihood that a mixed-race registrant will be the only available match for a patient classified as being of a single race, the recruitment of mixed race donors turns out to be highly cost-effective.
Highlights
Patients with leukemia and other blood diseases stand a good chance of recovery and a return to normal life if they receive a stem cell transplant from a living donor
Human human leukocyte antigen (HLA) types are determined by the pairs of alleles found in a small number of genetic loci located on the same chromosome
We estimated the distribution of HLA types, the probabilities of finding a matching donor for persons of mixed race, and the cost-effectiveness of adding donors of mixed race
Summary
Patients with leukemia and other blood diseases stand a good chance of recovery and a return to normal life if they receive a stem cell transplant from a living donor. For a transplant to be successful, the immunity responses of the donor and recipient must be controlled by matching human leukocyte antigen (HLA) systems. Finding a match is often difficult because the distribution of HLA types in the human population is extremely diffuse. While the distributions of different races have some overlap, the probability that two randomly selected individuals will match is higher if they are of the same race. Half of the population of European descent belong to types with frequency less than one in one hundred thousand, while twenty percent belong to types with a frequency of less than one in a million. The distribution of types for persons of Asian and African descent is even more diffuse
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