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      “It’s harder for the likes of us”: racially minoritised stem cell donation as ethico-racial imperative

      research-article
      Biosocieties
      Palgrave Macmillan UK
      Donation, Bone marrow, Race, Stem cells, STS, Kinship, Relatedness

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          Abstract

          How best are we to understand appeals to participate in a biomedical project that are based both on invoking shared racial identity, and on framing engagement as the clear moral course of action? Stem cell donor recruitment, which often focuses on engaging racially minoritised communities, provides useful insight into this question. This article proposes that it is not an essential mutual racial identity between the person asking and the person asked at play. Rather, it is the creative ‘doing’ of relatedness between people at the scale of race as well as family that coalesces into powerful appeals to participate. Through analysis of ethnographic, documentary and social media data, the paper argues that this work relies at least partly on framing donation as a duty of being part of a racialised community, which I describe here as an ethico-racial imperative, in which both race and responsibility become intertwined to compel participation in the biomedical project of donor registration.

          Supplementary Information

          The online version contains supplementary material available at 10.1057/s41292-021-00241-9.

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          Theory Construction in Qualitative Research

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            HLA match likelihoods for hematopoietic stem-cell grafts in the U.S. registry.

            Hematopoietic stem-cell transplantation (HSCT) is a potentially lifesaving therapy for several blood cancers and other diseases. For patients without a suitable related HLA-matched donor, unrelated-donor registries of adult volunteers and banked umbilical cord-blood units, such as the Be the Match Registry operated by the National Marrow Donor Program (NMDP), provide potential sources of donors. Our goal in the present study was to measure the likelihood of finding a suitable donor in the U.S. registry. Using human HLA data from the NMDP donor and cord-blood-unit registry, we built population-based genetic models for 21 U.S. racial and ethnic groups to predict the likelihood of identifying a suitable donor (either an adult donor or a cord-blood unit) for patients in each group. The models incorporated the degree of HLA matching, adult-donor availability (i.e., ability to donate), and cord-blood-unit cell dose. Our models indicated that most candidates for HSCT will have a suitable (HLA-matched or minimally mismatched) adult donor. However, many patients will not have an optimal adult donor--that is, a donor who is matched at high resolution at HLA-A, HLA-B, HLA-C, and HLA-DRB1. The likelihood of finding an optimal donor varies among racial and ethnic groups, with the highest probability among whites of European descent, at 75%, and the lowest probability among blacks of South or Central American descent, at 16%. Likelihoods for other groups are intermediate. Few patients will have an optimal cord-blood unit--that is, one matched at the antigen level at HLA-A and HLA-B and matched at high resolution at HLA-DRB1. However, cord-blood units mismatched at one or two HLA loci are available for almost all patients younger than 20 years of age and for more than 80% of patients 20 years of age or older, regardless of racial and ethnic background. Most patients likely to benefit from HSCT will have a donor. Public investment in donor recruitment and cord-blood banks has expanded access to HSCT. (Funded by the Office of Naval Research, Department of the Navy, and the Health Resources and Services Administration, Department of Health and Human Services.).
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              Anthropocene, Capitalocene, Plantationocene, Chthulucene: Making Kin

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                Author and article information

                Contributors
                r.g.williams@sheffield.ac.uk
                Journal
                Biosocieties
                Biosocieties
                Biosocieties
                Palgrave Macmillan UK (London )
                1745-8552
                1745-8560
                13 July 2021
                13 July 2021
                : 1-22
                Affiliations
                GRID grid.11835.3e, ISNI 0000 0004 1936 9262, Department of Sociological Studies, , The University of Sheffield, ; Elmfield Building, Northumberland Road, Sheffield, S10 2TU UK
                Author information
                http://orcid.org/0000-0002-4295-2582
                Article
                241
                10.1057/s41292-021-00241-9
                8275909
                34276806
                357094d2-741a-45fc-be9f-438e87fffb02
                © The Author(s) 2021

                Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.

                History
                : 2 July 2021
                Funding
                Funded by: FundRef http://dx.doi.org/10.13039/100004440, Wellcome Trust;
                Award ID: 212804/Z/18/Z
                Award Recipient :
                Categories
                Original Article

                Sociology
                donation,bone marrow,race,stem cells,sts,kinship,relatedness
                Sociology
                donation, bone marrow, race, stem cells, sts, kinship, relatedness

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