Hsu K C, Pinto-Agnello C, Gooley T, Malkki M, Dupont B, Petersdorf E W
Adult Allogeneic Blood and Marrow Transplantation Service, Memorial Hospital, Memorial Sloan-Kettering Cancer Center, New York, NY 10021, USA.
Tissue Antigens. 2007 Apr;69 Suppl 1:42-5. doi: 10.1111/j.1399-0039.2006.759_5.x.
Recognition of recipient human leukocyte antigen (HLA) class I ligand by donor natural killer cell killer immunoglobulin-like receptors (KIR) has been proposed as the basis for donor allograft reactivity against malignancy leading to reduction in posttransplant relapse and higher survival for acute myelogenous leukemia. Analysis of KIR ligand effects in 1770 patients undergoing myeloablative T-replete hematopoietic cell transplantation (HCT) from HLA-matched or mismatched unrelated donors showed that lack of KIR ligand in patients for inhibitory KIR was associated with lower hazards of relapse in leukemia patients with in HLA-mismatched transplants [hazard ratio (HR): 0.061; 95% confidence interval (CI): 0.43-0.85; P-value = 0.004]. Absence of HLA-C group 2 or HLA-Bw4 KIR ligands were each associated with lower hazards of relapse (HR: 0.47; 95% CI: 0.28-0.79; P-value = 0.004; HR: 0.56; 95% CI: 0.33-0.97; P-value = 0.04, respectively). Based on these analyses, recipient homozygosity for HLA-B or -C epitopes that define KIR ligands is likely to be a predictive factor for leukemia relapse following myeloablative HCT from unrelated donors. KIR genotyping for unrelated donors and recipients will clarify the role of these receptors in transplant outcome.
供体自然杀伤细胞杀伤免疫球蛋白样受体（KIR）识别受者人类白细胞抗原（HLA）I类配体，被认为是供体同种异体移植物对恶性肿瘤产生反应的基础，可导致急性髓性白血病移植后复发率降低和生存率提高。对1770例接受来自HLA匹配或不匹配无关供体的清髓性全量造血细胞移植（HCT）患者的KIR配体效应分析表明，在HLA不匹配移植的白血病患者中，缺乏抑制性KIR的患者KIR配体与较低的复发风险相关[风险比（HR）：0.061；95%置信区间（CI）：0.43 - 0.85；P值 = 0.004]。缺乏HLA - C 2组或HLA - Bw4 KIR配体均与较低的复发风险相关（HR分别为：0.47；95% CI：0.28 - 0.79；P值 = 0.004；HR：0.56；95% CI：0.33 - 0.97；P值 = 0.04）。基于这些分析，定义KIR配体的HLA - B或 - C表位的受者纯合性可能是无关供体清髓性HCT后白血病复发的预测因素。对无关供体和受者进行KIR基因分型将阐明这些受体在移植结果中的作用。
