The effect of KIR ligand incompatibility on the outcome of unrelated donor transplantation: A report from the Center for International Blood and Marrow Transplant Research, the European Blood and Marrow Transplant Registry, and the Dutch Registry
The effect of KIR ligand incompatibility on the outcome of unrelated donor transplantation: A report from the Center for International Blood and Marrow Transplant Research, the European Blood and Marrow Transplant Registry, and the Dutch Registry
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DOI：
10.1016/j.bbmt.2006.05.007
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发表时间：
2006-08-01
影响因子：
4.3
通讯作者：
Davies, Stella M.
中科院分区：
文献类型：
--
作者：
Farag, Sherif S.;Bacigalupo, Andrea;Davies, Stella M.
HLA I类等位基因（包括HLA - c）的匹配是非亲属供体移植结果的重要标准。然而，髓系恶性肿瘤的单倍型错配移植，在移植物抗宿主（GVH）方向上的杀伤免疫球蛋白样受体（KIR）配体错配，与移植物抗宿主病（GVHD）、复发率和死亡率较低相关。本研究探讨了KIR配体错配对非亲属供体移植结果的影响。使用Cox回归模型比较1571例非相关骨髓恶性肿瘤供体移植后的结果，其中供体-受体对为HILA-A， -B， -C和-DRB1匹配（n = 1004）， GVH KIR配体不匹配（n = 137），宿主-移植物（HVG） KIR配体不匹配（n = 170）， HLA-B和/或-C不匹配但KIR配体匹配（n = 260）。匹配移植后，治疗相关死亡率（TRM）、治疗失败和总死亡率最低。接受供体移植的患者在GVH或HVG方向上的KIR配体不匹配，以及在HLA-B和/或C上不匹配但在KIR配体上匹配的患者有相似的TRM率、治疗失败率和总死亡率。四组间白血病复发率无差异。这些结果不支持根据HI-A分型确定的KIR配体不匹配来选择非亲属供体。(C) 2006年美国血液和骨髓移植学会。
Matching for HLA class I alleles, including HILA-C, is an important criterion for outcome of unrelated donor transplantation. However, haplotype-mismatched transplantations for myeloid malignancies, mismatched for killer immunoglobulin-like receptor (KIR) ligands in the graft-versus-host (GVH) direction, is associated with lower rates of graft-versus-host disease (GVHD), relapse, and mortality. This study investigated the effect of KIR ligand mismatching on the outcome of unrelated donor transplantation. The outcomes after 1571 unrelated donor transplantations for myeloid malignancies where donor-recipient pairs were HILA-A, -B, -C, and -DRB1 matched (n = 1004), GVH KIR ligand-mismatched (n = 137), host-versus-graft (HVG) KIR ligand-mismatched (n = 170), and HLA-B and/or -C-mismatched but KIR ligand-matched (n = 260) were compared using Cox regression models. Treatment-related mortality (TRM), treatment failure, and overall mortality were lowest after matched transplantations. Patients who received grafts from donors mismatched at the KIR ligand in the GVH or HVG direction and mismatched at HLA-B and/or C but matched at the KIR ligand had similar rates of TRM, treatment failure, and overall mortality. There were no differences in leukemia recurrence between the 4 groups. These results do not support the choice of an unrelated donor on the basis of KIR ligand mismatch determined from HI-A typing. (C) 2006 American Society for Blood and Marrow Transplantation.