Abstract
Combinations of HLA and killer immunoglobulin-like receptors (KIR) may affect outcome in T-cell depleted haematopoietic stem cell transplantation (HSCT). The KIR gene family includes inhibitory (KIR2DL and 3DL) and activating receptors (KIR2DS). Ligands are HLA-C (KIR2D) and HLA-Bw4 (KIR3DL1) for inhibitory KIR and are still unknown for activating KIR. The impact of activating KIR genotypes from donor and recipient is poorly documented in HSCT outcome. Here, HLA and KIR genotypes were determined in 131 pairs from non-T-cell depleted HLA-identical sibling HSCT. No effect of ‘missing KIR ligand’ was detected on acute graft-versus-host disease (GVHD), relapse, survival or infections even in myeloid malignancies. However, additional activating KIR genes in the donor compared to the recipient's genotype or an identity between donor and recipient activating KIR genotypes was associated with a lower transplant-related mortality (TRM) (P=0.005) and in a multivariate analysis with a better survival (P=0.02, HR=0.28; P=0.013, HR=0.29) and a lower incidence of cytomegalovirus (CMV) reactivation (P=0.009, HR=0.36). These data highlight the impact of donor-activating KIR genes on TRM, overall survival and CMV reactivation in HLA-identical sibling HSCT.
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Acknowledgements
We thank Nathalie David, Françoise Fecamp, Monique Dourche, Catherine Ifrah, Estelle Galup, Françoise Grignon, Mauricette Touzot, Sylvie Quintin, Benoit Tixier, Fatna Mahroug and Hélène Bleux for technical assistance. This work was supported by 100% la vie, FRM (ARS 2000), Eurobank (QLRI-CT-2000-00010), Allostem FP6 (#503319) and by PRA (B01-07).
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Chen, C., Busson, M., Rocha, V. et al. Activating KIR genes are associated with CMV reactivation and survival after non-T-cell depleted HLA-identical sibling bone marrow transplantation for malignant disorders. Bone Marrow Transplant 38, 437–444 (2006). https://doi.org/10.1038/sj.bmt.1705468
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DOI: https://doi.org/10.1038/sj.bmt.1705468
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