title: Decreased infections in recipients of unrelated donor hematopoietic cell transplantation from donors with an activating KIR genotype.
abstract: Infectious complications following allogeneic hematopoietic cell transplantation (HCT) from unrelated donors (URD) result in significant morbidity. We hypothesized that recipients of a URD with an activating natural killer cell immunoglobulin-like receptor (KIR) (B/x) genotype would have decreased infectious complications because of enhanced natural killer (NK) cell function. We compared the infectious complications in 116 recipients of a graft from a donor with an A/A KIR (n = 44) genotype and a B/x KIR (n = 72) genotype. All recipients participated in the prospective National Marrow Donor Program infection project collecting infection data from conditioning until 6 months posttransplant. The cohort with a B/x donor had fewer initial bacterial infections by day 180 (A/A: 86%; 95% confidence interval [CI], 75-95; B/x: 68%; 95% CI, 57-78; P = .02). There was no difference in the incidence of viral or fungal infections. When accounting for multiple infections, fewer bacterial infections were seen in the B/x cohort (A/A: 3.55/patient; B/x: 2.63/patient; P = .09). During the study period, only 19 patients had no infections; of these, 15 had received cells from a B/x KIR donor. The role of donor KIR genotype on infection complications is intriguing and warrants further investigation.
authors.affiliation: H. Lee Moffitt Cancer Center Department of Blood and Marrow Transplantation, Tampa, Florida 33612, USA. marcie.tomblyn@moffitt.org
authors.forename: Marcie
authors.initials: M
authors.lastname: Tomblyn
authors.forename: Jo-Anne H
authors.initials: JA
authors.lastname: Young
authors.forename: Michael D
authors.initials: MD
authors.lastname: Haagenson
authors.forename: John P
authors.initials: JP
authors.lastname: Klein
authors.forename: Elizabeth A
authors.initials: EA
authors.lastname: Trachtenberg
authors.forename: Jan
authors.initials: J
authors.lastname: Storek
authors.forename: Stephen R
authors.initials: SR
authors.lastname: Spellman
authors.forename: Sarah
authors.initials: S
authors.lastname: Cooley
authors.forename: Jeffrey S
authors.initials: JS
authors.lastname: Miller
authors.forename: Daniel J
authors.initials: DJ
authors.lastname: Weisdorf
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001424:Bacterial Infections / Q000209:etiology / Q000517:prevention & control; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D005260:Female; D005838:Genotype; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects / Q000379:methods*; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D009181:Mycoses / Q000209:etiology / Q000517:prevention & control; D054340:Receptors, KIR / Q000235:genetics* / Q000276:immunology / Q000378:metabolism; D012307:Risk Factors; D014019:Tissue Donors; D014184:Transplantation, Homologous; D016896:Treatment Outcome; D014777:Virus Diseases / Q000209:etiology / Q000517:prevention & control; D055815:Young Adult
chemical_list: D054340:Receptors, KIR