title: T-cell alloreactivity dominates natural killer cell alloreactivity in minimally T-cell-depleted HLA-non-identical paediatric bone marrow transplantation.
abstract: Natural killer (NK) cell alloreactivity resulting from killer immunoglobulin-like receptor (KIR) ligand incompatibility improves outcomes in patients receiving extensively T-cell-depleted bone marrow (BM) grafts. Patients with KIR ligand incompatibility are at risk for donor T-cell alloreactivity. We investigated the relative significance of NK-cell and T-cell alloreactivity in 105 paediatric patients who received a minimally T-cell-depleted human leucocyte antigen-non-identical BM transplantation. Donor NK-cell incompatibility did not improve patient outcome [engraftment, graft-versus-host disease (GVHD), relapse or overall survival]. In contrast, donor T-cell incompatibility was a risk factor for acute GVHD, chronic GVHD and death. Thus, T-cell alloreactivity dominated that of NK cells in minimally T-cell-depleted grafts.
authors.affiliation: Department of Hematology-Oncology, St Jude Children's Research Hospital, Memphis, TN, USA.
authors.forename: Eric J
authors.initials: EJ
authors.lastname: Lowe
authors.forename: Victoria
authors.initials: V
authors.lastname: Turner
authors.forename: Rupert
authors.initials: R
authors.lastname: Handgretinger
authors.forename: Edwin M
authors.initials: EM
authors.lastname: Horwitz
authors.forename: Ely
authors.initials: E
authors.lastname: Benaim
authors.forename: Gregory A
authors.initials: GA
authors.lastname: Hale
authors.forename: Paul
authors.initials: P
authors.lastname: Woodard
authors.forename: Wing
authors.initials: W
authors.lastname: Leung
mesh_terms: D000293:Adolescent; D000328:Adult; D016026:Bone Marrow Transplantation / Q000276:immunology*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006086:Graft vs Host Disease / Q000276:immunology; D019337:Hematologic Neoplasms / Q000628:therapy*; D006650:Histocompatibility Testing; D006801:Humans; D007223:Infant; D007694:Killer Cells, Natural / Q000276:immunology*; D008212:Lymphocyte Depletion; D008297:Male; D015999:Multivariate Analysis; D012008:Recurrence; D012307:Risk Factors; D013601:T-Lymphocytes / Q000276:immunology*; D016896:Treatment Outcome