title: The impact of recipient HLA-Cw and donor killer immunoglobulin-like receptor genotyping on the outcome of patients receiving HLA-matched sibling donor hematopoietic stem cell transplantation for  myeloid malignancies.
abstract: BACKGROUND
  The alloreactivity of natural killer cell and certain subsets of T lymphocyte are regulated by the interaction between killer immunoglobulin-like receptors (KIRs) of donor cells and human leukocyte antigen (HLA)-class I molecules on target cells. The interaction has been shown to influence the outcome of allogeneic haematopoietic stem cell transplantation (HSCT). Homozygous C1 or C2 and heterozygous C1/C2 were divided by HLA-Cw typing and they influenced the outcome of HSCT.
  
  
  OBJECTIVE
  The purpose of the study was to analyse the impact of interaction between recipient HLA-Cw and donor KIR on outcome.
  
  
  METHODS
  The genotypes of recipient HLA-Cw ligands and donor KIRs were correlated with the clinical outcomes of 52 patients who received HLA-matched, sibling donor HSCT for myeloid malignancies.
  
  
  RESULTS
  The incidence of chronic graft versus host disease (GVHD) was significantly lower in C1 or C2 homozygotes than in C1/C2 heterozygotes (p = 0.000). Higher overall survival (OS) and disease-free survival (DFS) rates were observed in C1 or C2 homozygotes than in C1/C2 heterozygotes (OS, 81% ± 8% vs 54% ± 10%, p = 0.034; DFS, 81% ± 8% vs 54% ± 10%, p = 0.024). A lower incidence of chronic GVHD and higher OS and DFS were observed in the HLA-KIR mismatched group (chronic GVHD, p = 0.007; OS, 84% ± 7% vs 47% ± 13%, p = 0.003; DFS, 84% ± 7% vs 47% ± 13%, p = 0.002).
  
  
  CONCLUSIONS
  The interaction between recipient HLA ligand and donor KIR had a significant impact on the outcome of patients receiving matched sibling HSCT. C1/C2 heterozygotes or HLA-KIR matched patients may benefit from additional intensified therapy with better outcome.
authors.affiliation: Department of Haematology, Yantai Yu Hunag Ding Hospital, Yantai, China. huagnaw@yahoo.com.cn
authors.forename: Hua
authors.initials: H
authors.lastname: Wang
authors.forename: Yi
authors.initials: Y
authors.lastname: He
authors.forename: Wen-jing
authors.initials: WJ
authors.lastname: Zhai
authors.forename: Mei
authors.initials: M
authors.lastname: Wang
authors.forename: Zheng
authors.initials: Z
authors.lastname: Zhou
authors.forename: Ying-xin
authors.initials: YX
authors.lastname: Zhao
authors.forename: Si-zhou
authors.initials: SZ
authors.lastname: Feng
authors.forename: Ming-zhe
authors.initials: MZ
authors.lastname: Han
mesh_terms: D000293:Adolescent; D000328:Adult; D018572:Disease-Free Survival; D005260:Female; D005838:Genotype; D006086:Graft vs Host Disease / Q000453:epidemiology / Q000276:immunology* / Q000401:mortality; D015236:HLA-C Antigens / Q000235:genetics / Q000276:immunology*; D018380:Hematopoietic Stem Cell Transplantation / Q000401:mortality; D006579:Heterozygote; D006650:Histocompatibility Testing; D006720:Homozygote; D006801:Humans; D007951:Leukemia, Myeloid / Q000276:immunology / Q000401:mortality / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D054340:Receptors, KIR / Q000235:genetics / Q000276:immunology*; D012008:Recurrence; D035781:Siblings; D019172:Transplantation Conditioning; D014184:Transplantation, Homologous; D055815:Young Adult
chemical_list: D015236:HLA-C Antigens; D054340:Receptors, KIR