Leukemia, 2009-03, Vol.23 (3), p.492-500
2009
Details
- Autor(en) / Beteiligte
- Titel
- KIR-ligand incompatibility in the graft-versus-host direction improves outcomes after umbilical cord blood transplantation for acute leukemia
- Ist Teil von
- Leukemia, 2009-03, Vol.23 (3), p.492-500
- Ort / Verlag
- England: Nature Publishing Group
- Erscheinungsjahr
- 2009
- Link zum Volltext
- Quelle
- Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals
- Beschreibungen/Notizen
- Donor killer cell immunoglobulin-like receptor (KIR)-ligand incompatibility is associated with decreased relapse incidence (RI) and improved leukemia-free survival (LFS) after haploidentical and HLA-mismatched unrelated hematopoietic stem cell transplantation. We assessed outcomes of 218 patients with acute myeloid leukemia (AML n=94) or acute lymphoblastic leukemia (n=124) in complete remission (CR) who had received a single-unit unrelated cord blood transplant (UCBT) from a KIR-ligand-compatible or -incompatible donor. Grafts were HLA-A, -B or -DRB1 matched (n=21) or mismatched (n=197). Patients and donors were categorized according to their degree of KIR-ligand compatibility in the graft-versus-host direction by determining whether or not they expressed HLA-C group 1 or 2, HLA-Bw4 or HLA-A3/-A11. Both HLA-C/-B KIR-ligand- and HLA-A-A3/-A11 KIR-ligand-incompatible UCBT showed a trend to improved LFS (P=0.09 and P=0.13, respectively). Sixty-nine donor-patient pairs were HLA-A, -B or -C KIR-ligand incompatible and 149 compatible. KIR-ligand-incompatible UCBT showed improved LFS (hazards ratio=2.05, P=0.0016) and overall survival (OS) (hazards ratio=2.0, P=0.004) and decreased RI (hazards ratio=0.53, P=0.05). These results were more evident for AML transplant recipients (2-year LFS and RI with or without KIR-ligand incompatibility 73 versus 38% (P=0.012), and 5 versus 36% (P=0.005), respectively). UCBT for acute leukemia in CR from KIR-ligand-incompatible donors is associated with decreased RI and improved LFS and OS.
- Sprache
- Englisch
- Identifikatoren
- ISSN: 0887-6924eISSN: 1476-5551DOI: 10.1038/leu.2008.365Titel-ID: cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_7101531
- Format
- –
- Schlagworte
- Acute Disease, Acute leukemia, Acute lymphoblastic leukemia, Acute myeloid leukemia, Adolescent, Adult, Aged, Blood, Blood & organ donations, Blood banks, Bone marrow, Care and treatment, Child, Child, Preschool, Compatibility, Cord blood, Cord Blood Stem Cell Transplantation, Donors, Drb1 protein, Female, Fetal blood, Graft versus host reaction, Graft vs Leukemia Effect - immunology, Grafting, Hazards, Health aspects, Health hazards, Hematology, Hematopoietic stem cells, Herpesvirus 4, Human - physiology, Histocompatibility, Histocompatibility antigen HLA, HLA Antigens - immunology, Humans, Immunoglobulins, Incidence, Incompatibility, Infant, Killer cell immunoglobulin-like receptors, Killer Cells, Natural - immunology, Leukemia, Leukemia - immunology, Leukemia - therapy, Leukemia - virology, Ligands, Ligands (Biochemistry), Lymphatic leukemia, Male, Methods, Middle Aged, Peptides, Properties, Receptors, KIR - immunology, Remission, Remission (Medicine), Remission Induction, Retrospective Studies, Risk factors, Stem cell transplantation, Stem cells, Survival, Transplantation, Transplantation, Homologous - immunology, Transplants & implants, Treatment Outcome, Umbilical cord, Virus Activation, Young Adult