title: Clinical impact of natural killer cell reconstitution after allogeneic hematopoietic transplantation.
abstract: Although the optimal donor for allogeneic hematopoietic stem cell transplantation is a human leukocyte antigen (HLA)-matched sibling, 75% of patients do not have a match and alternatives are matched unrelated volunteers, unrelated umbilical cord blood units, and full HLA-haplotype-mismatched family members. This review will focus on the open issues of allogeneic hematopoietic transplantation and on the benefits of natural killer (NK) cell alloreactivity and its underlying mechanisms. Donor-versus-recipient NK cell alloreactivity derives from a mismatch between inhibitory receptors for self major histocompatibility complex (MHC) class I molecules on donor NK clones and the MHC class I ligands on recipient cells. These NK clones sense the missing expression of the self MHC class I allele on the allogeneic targets ("missing self") and mediate alloreactions. Here, we review the translation of NK cell allorecognition into the clinical practice of allogeneic hematopoietic transplantation and discuss how it has opened innovative perspectives in the cure of leukemia.
authors.affiliation: Division of Hematology and Clinical Immunology, Department of Clinical and Experimental Medicine, University of Perugia, Ospedale Santa Maria della Misericordia, Perugia, Italy. velardi@unipg.it
authors.forename: Andrea
authors.initials: A
authors.lastname: Velardi
authors.forename: Loredana
authors.initials: L
authors.lastname: Ruggeri
authors.forename: Antonella
authors.initials: A
authors.lastname: Mancusi
authors.forename: Emanuela
authors.initials: E
authors.lastname: Burchielli
authors.forename: Katia
authors.initials: K
authors.lastname: Perruccio
authors.forename: Franco
authors.initials: F
authors.lastname: Aversa
authors.forename: Massimo F
authors.initials: MF
authors.lastname: Martelli
mesh_terms: D000818:Animals; D006084:Graft Rejection / Q000276:immunology; D006086:Graft vs Host Disease; D006239:Haplotypes; D018380:Hematopoietic Stem Cell Transplantation; D015395:Histocompatibility Antigens Class I / Q000276:immunology; D006801:Humans; D007694:Killer Cells, Natural / Q000276:immunology*; D007938:Leukemia / Q000628:therapy; D014184:Transplantation, Homologous / Q000276:immunology*
chemical_list: D015395:Histocompatibility Antigens Class I