Details

Autor(en) / Beteiligte

• Yokoyama, Hisayuki
• Kanda, Junya
• Kawahara, Yuta
• Uchida, Naoyuki
• Tanaka, Masatsugu
• Takahashi, Satoshi
• Onizuka, Makoto
• Noguchi, Yuma
• Ozawa, Yukiyasu
• Katsuoka, Yuna
• Ota, Shuichi
• Ohta, Takanori
• Kimura, Takafumi
• Kanda, Yoshinobu
• Ichinohe, Tatsuo
• Atsuta, Yoshiko
• Nakasone, Hideki
• Morishima, Satoko

Titel

Reduced leukemia relapse through cytomegalovirus reactivation in killer cell immunoglobulin-like receptor-ligand-mismatched cord blood transplantation

Ist Teil von

• Bone marrow transplantation (Basingstoke), 2021-06, Vol.56 (6), p.1352-1363

Ort / Verlag

England: Nature Publishing Group

Erscheinungsjahr

2021

Quelle

MEDLINE

Beschreibungen/Notizen

• Cytomegalovirus (CMV) reactivation in cord blood transplantation (CBT) may result in the proliferation and maturation of natural killer (NK) cells. Similarly, a mismatch of the killer cell immunoglobulin-like receptor (KIR)-ligand induces NK cell activation. Therefore, if CMV reactivation occurs in the presence of KIR-ligand mismatch, it might improve CBT outcomes. We assessed the difference in the effect of CMV reactivation in the presence of KIR-ligand mismatch on disease relapse in the graft-versus-host direction. A total of 2840 patients with acute myeloid leukemia, acute lymphoblastic leukemia, myelodysplastic syndrome, and chronic myeloid leukemia were analyzed. Among those with a HLA-Bw4/A3/A11 (KIR3DL-ligand) mismatch, CMV reactivation up to 100 days following CBT had a favorable impact on relapse (18.9% vs. 32.9%, P = 0.0149). However, this effect was not observed in cases without the KIR3DL-ligand mismatch or in those with or without a HLA-C1/C2 (KIR2DL-ligand) mismatch. The multivariate analysis suggested that CMV reactivation had a favorable effect on relapse only in cases with a KIR3DL-ligand mismatch (hazard ratio 0.54, P = 0.032). Moreover, the interaction effect between CMV reactivation and KIR3DL-ligand mismatch on relapse was significant (P = 0.039). Thus, our study reveals the association between KIR-ligand mismatches and CMV reactivation, which will enhance CBT outcomes.