KIR-ligand incompatibility in the graft-versus-host direction improves outcomes after umbilical cord blood transplantation for acute leukemia.
作者： R Willemze , CA Rodrigues , M Labopin , G Sanz , G Michel
DOI: 10.1038/LEU.2008.365
关键词:
摘要: Donor killer cell immunoglobulin-like receptor (KIR)-ligand incompatibility is associated with decreased relapse incidence (RI) and improved leukemia-free survival (LFS) after haploidentical HLA-mismatched unrelated hematopoietic stem transplantation. We assessed outcomes of 218 patients acute myeloid leukemia (AML n=94) or lymphoblastic (n=124) in complete remission (CR) who had received a single-unit cord blood transplant (UCBT) from KIR-ligand-compatible -incompatible donor. Grafts were HLA-A, -B -DRB1 matched (n=21) mismatched (n=197). Patients donors categorized according to their degree KIR-ligand compatibility the graft-versus-host direction by determining whether not they expressed HLA-C group 1 2, HLA-Bw4 HLA-A3/-A11. Both HLA-C/-B KIR-ligand- HLA-A-A3/-A11 KIR-ligand-incompatible UCBT showed trend LFS (P=0.09 P=0.13, respectively). Sixty-nine donor-patient pairs -C incompatible 149 compatible. (hazards ratio=2.05, P=0.0016) overall (OS) ratio=2.0, P=0.004) RI ratio=0.53, P=0.05). These results more evident for AML recipients (2-year without 73 versus 38% (P=0.012), 5 36% (P=0.005), CR OS.
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