title: KIR alloreactivity based on the receptor-ligand model is associated with improved clinical outcomes of allogeneic hematopoietic stem cell transplantation: Result of single center prospective study.
abstract: Receptors on natural killer (NK) cells, named killer immunoglobulin-like receptors (KIRs), recognize HLA class I alleles. Patients (n=59) who received allogeneic hematopoietic stem cell transplantation (HSCT) from either a related (n=17) or unrelated donor (n=42) in Samsung Medical Center (Seoul, South Korea) were included. KIR mismatch was defined as incompatibility between the donor KIR and recipient KIR ligand (receptor-ligand model), and all cases were classified into the two broad haplotypes of KIR A and B. Patients with acute leukemia (n=51, 86.4%) or myelodysplastic syndrome (n=8, 13.6%) were included. Peripheral blood was used as the source of stem cells in all patients. Kaplan-Meier survival curves for overall survival (OS), disease-free survival (DFS), and cumulative incidence of relapse (CIR) favored recipients with a KIR-mismatched donor, although the differences were not statistically significant. In multivariate analysis, KIR mismatch was an independent prognostic indicator of a better OS (P=0.010, HR=0.148, 95% CI 0.034-0.639), DFS (P=0.022, HR=0.237, 95% CI 0.069-0.815), and CIR (P=0.031, HR=0.117, 95% CI 0.017-0.823). OS, DFS, and CIR did not differ significantly between the KIR A and B haplotypes.
authors.affiliation: Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University of School of Medicine, Seoul, Republic of Korea.
authors.forename: Silvia
authors.initials: S
authors.lastname: Park
authors.affiliation: Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University of School of Medicine, Seoul, Republic of Korea.
authors.forename: Kihyun
authors.initials: K
authors.lastname: Kim
authors.affiliation: Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University of School of Medicine, Seoul, Republic of Korea.
authors.forename: Jun Ho
authors.initials: JH
authors.lastname: Jang
authors.affiliation: Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University of School of Medicine, Seoul, Republic of Korea.
authors.forename: Seok Jin
authors.initials: SJ
authors.lastname: Kim
authors.affiliation: Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University of School of Medicine, Seoul, Republic of Korea.
authors.forename: Won Seog
authors.initials: WS
authors.lastname: Kim
authors.affiliation: Department of Laboratory Medicine and Genetics, Samsung Medical Center, Sungkyunkwan University of School of Medicine, Seoul, Republic of Korea. Electronic address: esk.kang@samsung.com.
authors.forename: Eun-Suk
authors.initials: ES
authors.lastname: Kang
authors.affiliation: Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University of School of Medicine, Seoul, Republic of Korea. Electronic address: leukemia1@skku.edu.
authors.forename: Chul Won
authors.initials: CW
authors.lastname: Jung
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D006680:HLA Antigens / Q000276:immunology; D006239:Haplotypes; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects; D006801:Humans; D007938:Leukemia / Q000235:genetics / Q000276:immunology / Q000401:mortality / Q000628:therapy; D008024:Ligands; D008297:Male; D008875:Middle Aged; D063868:Patient Outcome Assessment; D011379:Prognosis; D011446:Prospective Studies; D054340:Receptors, KIR / Q000235:genetics / Q000276:immunology*; D016019:Survival Analysis; D019172:Transplantation Conditioning; D014184:Transplantation, Homologous; D055815:Young Adult
chemical_list: D006680:HLA Antigens; D008024:Ligands; D054340:Receptors, KIR
keywords: Allogeneic hematopoietic stem cell transplantation; Alloreactivity; KIR; NK cell