Faculty Collaboration Database

Killer Cell Immunoglobulin-Like Receptor-Ligand Matching and Outcomes after Unrelated Cord Blood Transplantation in Acute Myeloid Leukemia. Biol Blood Marrow Transplant 2016 Jul;22(7):1284-1289

Date

04/20/2016

Pubmed ID

27090957

Pubmed Central ID

PMC4915071

DOI

10.1016/j.bbmt.2016.04.007

Scopus ID

2-s2.0-84975275493 (requires institutional sign-in at Scopus site)   28 Citations

Abstract

The effect of killer cell immunoglobulin-like receptor (KIR)-ligand matching on outcomes after unrelated cord blood (CB) transplantation was studied in 461 patients with acute myeloid leukemia, categorizing KIR ligand for HLA-C groups C1 and C2 and Bw4. Donor-recipient HLA matching considered allele-level matching at HLA-A, -B, -C, and -DRB1. Separate analyses were conducted for 6-7/8 HLA-matched and 3-5/8 HLA-matched transplants because HLA matching confounded KIR-ligand matching (ie, KIR-ligand mismatching was less likely with better HLA matching). All patients received single CB unit and myeloablative conditioning. There were no significant differences in nonrelapse mortality (NRM), relapse, and overall mortality by KIR-ligand match status. However, among recipients of 3-5/8 HLA-matched transplants, NRM (HR, 2.26; P = .008) and overall mortality (HR, 1.78; P = .008) but not relapse were higher with KIR-ligand mismatched (host-versus-graft direction) compared with KIR-ligand matched transplants. These data do not support selecting CB units based on KIR-ligand match status for transplants mismatched at 1 or 2 HLA loci. Although transplants mismatched at 3 or more HLA loci are not recommended, avoiding KIR-ligand mismatching in this setting lowers mortality risks.

Author List

Rocha V, Ruggeri A, Spellman S, Wang T, Sobecks R, Locatelli F, Askar M, Michel G, Arcese W, Iori AP, Purtill D, Danby R, Sanz GF, Gluckman E, Eapen M, Eurocord, Cord Blood Committee Cellular Therapy Immunobiology Working Party of the European Group for Blood and Marrow Transplantation, Netcord, and the Center for International Blood and Marrow Transplant Research

Authors

Mary Eapen MBBS, DCh, MRCPI, MS Professor in the Medicine department at Medical College of Wisconsin
Tao Wang PhD Associate Professor in the Institute for Health and Equity department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adolescent
Cord Blood Stem Cell Transplantation
Female
HLA-C Antigens
Histocompatibility
Histocompatibility Antigens Class I
Humans
Leukemia, Myeloid, Acute
Ligands
Male
Precursor Cell Lymphoblastic Leukemia-Lymphoma
Receptors, KIR
Recurrence
Survival Analysis
Transplantation Conditioning
Treatment Outcome
Unrelated Donors