Decreased infections in recipients of unrelated donor hematopoietic cell transplantation from donors with an activating KIR genotype.
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.
Tomblyn
Marcie
M
H. Lee Moffitt Cancer Center Department of Blood and Marrow Transplantation, Tampa, Florida 33612, USA. marcie.tomblyn@moffitt.org
Young
Jo-Anne H
JA
Haagenson
Michael D
MD
Klein
John P
JP
Trachtenberg
Elizabeth A
EA
Storek
Jan
J
Spellman
Stephen R
SR
Cooley
Sarah
S
Miller
Jeffrey S
JS
Weisdorf
Daniel J
DJ
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
D054340:Receptors, KIR