Improved outcome in HLA-identical sibling hematopoietic stem cell transplantation for acute myelogenous leukemia (AML) predicted by KIR and HLA genotypes.
Posted by rob on February 27, 2005 under Uncategorized | 
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Improved outcome in HLA-identical sibling hematopoietic stem cell transplantation for acute myelogenous leukemia (AML) predicted by KIR and HLA genotypes.
Hsu KC, Keever-Taylor CA, Wilton A, Pinto C, Heller G, Arkun K, O’reilly RJ, Horowitz MM, Dupont B
Blood. 2005 Feb 24;
Inhibitory killer Ig-like receptors (KIR) recognize HLA-C and -B epitopes on target cells, thereby regulating natural killer (NK) cell activity. In 178 patients receiving T-cell depleted HLA-identical sibling transplants for CML, ALL, AML, and MDS, analysis of donor KIR genotype with HLA genotype demonstrated that 62.9% of the patients lacked an HLA ligand for donor inhibitory KIR. Lack of HLA ligand for donor inhibitory KIR (“missing KIR ligand”) had no effect on disease-free survival (DFS), overall survival (OS), or relapse in patients receiving transplants for CML and ALL. There was, however, a significant missing KIR ligand effect in AML and MDS on DFS (p=0.014, HR 0.53, 95% CI 0.28-0.88) and OS (p=0.03, HR 0.53, 95% CI 0.3-0.93). Incidence of relapse was also lower in AML and MDS patients lacking HLA ligand for donor inhibitory KIR (p=0.04, HR 0.41, 95% CI 0.18-0.97). AML and MDS patients lacking two HLA ligands for donor inhibitory KIR had the highest DFS (p=0.002) and OS (p=0.003). There was no significant contribution of donor activating KIR to transplant outcome in these patients. These data indicate that absence of class I ligand in the recipient for donor inhibitory KIR can be a prognostic factor for transplant outcome in HLA-identical sibling transplants, and that lack of either HLA-C or -B ligands for donor inhibitory KIR can contribute to improved outcome in AML and MDS.
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