title: [The role of different KIR haplotypes in haplo-identical hematopoietic stem cell transplantation].
abstract: OBJECTIVE
  To investigate the role of different immunoglobulin- like receptor (KIR)haplotypes in haplo- identical hematopoietic stem cell transplantation (HSCT).
  
  
  METHODS
  Killer cell KIR genotyping was performed on 468 individuals from 156 unrelated families by PCR-SSP. A total of 624 KIR haplotypes from the parents were used for haplotype analysis. Ninety-two patients received haplo-identical HSCT from one of the parents.
  
  
  RESULTS
  The family study showed segregation of one A haplotype and at least 20 unique B haplotypes. The frequency of haplotype A was 72.92% (455/624). The most commonly observed haplotypes in group B were B1, B2, and B3, present at a frequency of 10.26%, 5.77%, and 4.48%, respectively. Compared to KIR gene matched donors (n=17), grafts from KIR gene mismatched donors (n= 14) had a positive effect on survival after haplo- identical HSCT for AML/MDS patients (OS: 88.2%vs 42.9%,P=0.015; RFS: 88.2%vs 35.7%,P=0.007). No effect was observed for ALL/NHL patients (OS: 76.0%vs 75.0%,P=0.727; RFS: 68.0%vs 65.0%,P=0.866). A significantly lower survival rate was observed for transplants from AA (n=52) and AB1/AB2 donors (n=15), compared to other group Bx donors (n=25) (OS: 53.3%vs 96.0%,P=0.017; RFS: 53.3%vs 92.0%,P=0.019). Meanwhile, the risk of relapse was much higher in AA group (n=52) compared to Bx group (n=40) (25.0%vs 5.0%,P=0.009). A higher risk of TRM was observed in AB1/AB2 group (P=0.012). In addition, transplant from donors carried Cen-B was associated with an increased survival compared with Cen-A homozygous donors (OS: 94.7%vs 68.5%,P=0.036; RFS: 89.5%vs 64.4%,P=0.045).
  
  
  CONCLUSIONS
  Overall, KIR genotyping and haplotype analyses should be useful for selection of the most optimal donors with favorable KIR gene grafts. KIR gene mismatch donors should be preferred for AML/MDS patients. Selecting donors carried Cen- B and avoiding the selection of donors of KIR genotype AA/AB1/AB2 was strongly advisable for haplo-identical HSCT.
authors.affiliation: Jiangsu Institute of Hematology, First Affiliated Hospital of Soochow University, Suzhou Institute of Blood and Marrow Transplantation, Suzhou 215006, China.
authors.forename: Xiaojing
authors.initials: X
authors.lastname: Bao
authors.forename: Jun
authors.initials: J
authors.lastname: He
authors.forename: Miao
authors.initials: M
authors.lastname: Wang
authors.forename: Xiaoni
authors.initials: X
authors.lastname: Yuan
authors.forename: Yang
authors.initials: Y
authors.lastname: Li
authors.forename: Tengteng
authors.initials: T
authors.lastname: Zhang
authors.forename: Lingjie
authors.initials: L
authors.lastname: Li
authors.forename: Luyao
authors.initials: L
authors.lastname: Chen
authors.forename: Depei
authors.initials: D
authors.lastname: Wu
mesh_terms: D002908:Chronic Disease; D005838:Genotype; D006239:Haplotypes; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D007694:Killer Cells, Natural; D015470:Leukemia, Myeloid, Acute / Q000628:therapy*; D009364:Neoplasm Recurrence, Local; D054340:Receptors, KIR / Q000235:genetics*; D015996:Survival Rate; D014019:Tissue Donors
chemical_list: D054340:Receptors, KIR