KIR alloreactivity based on the receptor-ligand model is associated with improved clinical outcomes of allogeneic hematopoietic stem cell transplantation: Result of single center prospective study

被引:10
作者
Park, Silvia [1 ]
Kim, Kihyun [1 ]
Jang, Jun Ho [1 ]
Kim, Seok Jin [1 ]
Kim, Won Seog [1 ]
Kang, Eun-Suk [2 ]
Jung, Chul Won [1 ]
机构
[1] Sungkyunkwan Univ, Sch Med, Samsung Med Ctr, Dept Med,Div Hematol Oncol, Seoul 135710, South Korea
[2] Sungkyunkwan Univ, Sch Med, Samsung Med Ctr, Dept Lab Med & Genet, Seoul 135710, South Korea
关键词
NK cell; KIR; Alloreactivity; Allogeneic hematopoietic stem cell transplantation; BONE-MARROW-TRANSPLANTATION; LEUKEMIA; DIVERSITY; SURVIVAL; GENES; RECOGNITION; POPULATIONS; INFECTIONS; HAPLOTYPES; MOLECULES;
D O I
10.1016/j.humimm.2015.09.009
中图分类号
R392 [医学免疫学]; Q939.91 [免疫学];
学科分类号
100102 ;
摘要
Receptors on natural killer (NK) cells, named killer immunoglobulin-like receptors (KIRs), recognize HLA class I alleles. Patients (n = 59) who received allogeneic hematopoietic stem cell transplantation (HSCT) from either a related (n = 17) or unrelated donor (n = 42) in Samsung Medical Center (Seoul, South Korea) were included. KIR mismatch was defined as incompatibility between the donor KIR and recipient KIR ligand (receptor-ligand model), and all cases were classified into the two broad haplotypes of KIR A and B. Patients with acute leukemia (n = 51, 86.4%) or myelodysplastic syndrome (n = 8, 13.6%) were included. Peripheral blood was used as the source of stem cells in all patients. Kaplan-Meier survival curves for overall survival (OS), disease-free survival (DFS), and cumulative incidence of relapse (CIR) favored recipients with a KIR-mismatched donor, although the differences were not statistically significant. In multivariate analysis, KIR mismatch was an independent prognostic indicator of a better OS (P = 0.010, HR = 0.148, 95% CI 0.034-0.639), DFS (P = 0.022, HR = 0.237, 95% CI 0.069-0.815), and CIR (P = 0.031, HR = 0.117, 95% CI 0.017-0.823). OS, DFS, and CIR did not differ significantly between the KIR A and B haplotypes. (C) 2015 Published by Elsevier Inc. on behalf of American Society for Histocompatibility and Immunogenetics.
引用
收藏
页码:636 / 643
页数:8
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