4.6 Article

Low number of donor activating killer immunoglobulin-like receptors (KIR) genes but not KIR-ligand mismatch prevents relapse and improves disease-free survival in leukemia patients after in vivo T-Cell depleted unrelated stem cell transplantation

期刊

TRANSPLANTATION
卷 82, 期 8, 页码 1024-1030

出版社

LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/01.tp.0000235859.24513.43

关键词

killer Ig-like receptor; KIR genotyping; allogeneic stem cell transplantation; unrelated donor; KIR ligand

向作者/读者索取更多资源

Background. The effect of natural killer (NK) cell alloreactivity on outcome of unrelated stem cell transplantation (SCT) remains controversial. Killer immunoglobulin-like receptors (KIRs) recognize human leukocyte antigen C and B epitopes on target cells, thereby regulating NK cell activity. The KIR genes are polymorphic and two broad haplotypes exist: KIR-haplotype A mainly encode for inhibitory receptors and only for one activating (KIR2DS4), whereas the group B haplotype encodes more for activating KIRs (KIR2DS1, KIR2DS2, KIR2DS3, KIR2DS5 und KIR3DS1). Methods. The impact of KIR ligand mismatch on the number of activating and inhibitory donor KIR genes and on KIR-haplotype was studied on outcome of 142 patients with leukemia, who received standard myeloablative conditioning followed by in vivo T-cell depleted (ATG) unrelated Results. In a multivariate analysis KIR ligand mismatch had significantly higher treatment related mortality (RR 2.206, P=0.03), resulting in reduced overall (RR 2.015, P=0.02) and disease-free survival (RR 1.924, P=0.03). In contrast, SCT from donors with group A haplotype (P=0.003) or with low number of activating KIR genes (P=0.005) resulted in reduced relapse rate with improved disease-fee survival (P=0.04). This effect was seen only in acute myeloid leukemia/myelodysplastic syndrome and to a less extent in chronic myeloid leukemia. No effect was seen for acute lymphoblastic leukemia. Conclusions. After in vivo T-cell depleted (ATG) unrelated stem cell transplantation with donors carrying low number of activating KIR genes (group A KIR haplotype), the risk of relapse is reduced and resulted in a significantly better disease-free survival.

作者

我是这篇论文的作者
点击您的名字以认领此论文并将其添加到您的个人资料中。

评论

主要评分

4.6
评分不足

次要评分

新颖性
-
重要性
-
科学严谨性
-
评价这篇论文

推荐

暂无数据
暂无数据