title: Natural killer cell alloreactivity in haploidentical hematopoietic stem cell transplantation.
abstract: Natural killer (NK) cells are primed to kill by several activating receptors. NK cell killing of autologous cells is prevented because NK cells coexpress inhibitory receptors (killer cell immunoglobulin-like receptors [KIR]) that recognize groups of (self) major histocompatibility complex class I alleles. Because KIRs are clonally distributed, the NK cell population in any individual are constituted of a repertoire with a variety of class I specificities. NK cells in the repertoire mediate alloreactions when the allogeneic targets do not express the class I alleles that block them. After haploidentical hematopoietic transplantation, NK cell-mediated donor-versus-recipient alloresponses reduce the risk of relapse in acute myeloid leukemia patients while improving engraftment and protecting against graft-versus-host disease. High-resolution molecular HLA typing of recipient and donor, positive identification of donor KIR genes, and, in some cases, functional assessment of donor NK clones identify haploidentical donors who are able to mount donor-versus-recipient NK alloreactions.
authors.affiliation: Division of Haematology and Clinical Immunology, Department of Clinical and Experimental Medicine, University of Perugia, Perugia, Italy.
authors.forename: Loredana
authors.initials: L
authors.lastname: Ruggeri
authors.forename: Marusca
authors.initials: M
authors.lastname: Capanni
authors.forename: Antonella
authors.initials: A
authors.lastname: Mancusi
authors.forename: Katia
authors.initials: K
authors.lastname: Perruccio
authors.forename: Emanuela
authors.initials: E
authors.lastname: Burchielli
authors.forename: Massimo F
authors.initials: MF
authors.lastname: Martelli
authors.forename: Andrea
authors.initials: A
authors.lastname: Velardi
mesh_terms: D006238:Haploidy; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D007519:Isoantigens / Q000276:immunology*; D007694:Killer Cells, Natural / Q000276:immunology*
chemical_list: D007519:Isoantigens
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