The impact of donor full-length KIR2DS4 in the development of acute and chronic GVHD after unrelated allogeneic HSCT

被引:3
作者
An, Kang [1 ]
Li, Benshang [2 ]
Luo, Changying [2 ]
Wang, Jianmin [2 ]
Luo, Chengjuan [2 ]
Chen, Jing [2 ]
机构
[1] Shanghai Jiao Tong Univ, Sch Med, Dept Pediat Intens Care Unit, Shanghai Childrens Med Ctr, Shanghai, Peoples R China
[2] Shanghai Jiao Tong Univ, Sch Med, Dept Hematol & Oncol, Shanghai Childrens Med Ctr, 1678 Dongfang Rd, Shanghai 200127, Peoples R China
关键词
acute GVHD; allogeneic hematopoietic SCT; chronic GVHD; KIR2DS4; NK cell; VERSUS-HOST-DISEASE; STEM-CELL TRANSPLANTATION; BONE-MARROW-TRANSPLANTATION; KIR LIGAND INCOMPATIBILITY; RISK-FACTORS; HLA-C; B HAPLOTYPES; CORD-BLOOD; SURVIVAL; GENES;
D O I
10.1111/petr.13728
中图分类号
R72 [儿科学];
学科分类号
100202 ;
摘要
Background Killer Ig-like receptor 2DS4 (KIR2DS4) is the most prevalent activating killer Ig-like receptor gene. It is divergent and encodes either full-length or deleted allele variants. The studies of donor killer KIR2DS4 in unrelated allogeneic hematopoietic stem cell transplantations were limited. Methods KIR and HLA genotyping were determined in 75 pairs of Chinese pediatric hematologic malignancy patients. Results Among the 75 donor-recipient pairs, 77.3% (58/75) of the donors were positive for full-length KIR2DS4 and 22.7% (17/75) were negative. Patients who had donors positive for full-length KIR2DS4 had higher cumulative incidence of aGVHD than patients whose donor negative for full-length KIR2DS4 (86.2% versus 76.5%,P = .038). Multivariate analysis showed full-length KIR2DS4 was the significant factor for I-IV aGVHD (HR = 2.166, 95% CI: 1.01-4.26,P = .025). Subgroup analysis showed that AML and CML patients who received donors negative for full-length KIR2DS4 have a higher cumulative incidences of cGVHD (75% vs 62%,P = .008). There were no significant effects of full-length KIR2DS4 on overall survival (P = .13), relapse-free survival (P = .14), CMV reactivation (P = .52), and relapse (HR = 0.38, 95% CI: 0.09-1.6,P = .1875). Conclusions Our findings indicated a significant correlation of donor full-length KIR2DS4 on aGVHD and cGVHD. These results suggested that combining KIR and HLA genotyping may help make a better sense of transplants in these patients.
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