Zhang Xian, Zhang Yan-Ling, Wang Jian-Ling, Tong Chun-Rong, Cai Peng, Liu Hong-Xing, Wang Jing-Bo, Cao Xing-Yu, Ying Yu-Ming, Wu Tong
Beijing Daopei Hospital, Beijing 100049, China.
Zhonghua Xue Ye Xue Za Zhi. 2011 Aug;32(8):525-8.
To investigate the effect of inhibitory and activating KIRs on a cohort of Chinese leukemia patients who received haplo-identical hematopoietic stem cell transplantation (HSCT).
Donor's inhibitory and activating KIRs and recipient's HLA-C from 47 cases who received haplo-identical HSCT were tested by PCR-SSP. 2 year overall survival (OS), incidence of severe (grade III to IV) acute GVHD (aGVHD) and relapse rate (RR) were analyzed.
(1) According to Matched (M) vs Mis-Matched (MM) between donor's inhibitory KIR and recipient's HLA-C1/C2 subgroup, 2 year OS rate in M group [(87.5 +/- 8.3)%] was significantly higher than that in MM group (54.5 +/- 9.0)%, (P = 0.03). Lower incidence of relapse rate was seen in M group than in M/MM groups [0 vs (25.4 +/- 9.5)%, P = 0.05]. In 30 cases of myeloid leukemia patients, there was lower RR in M group than in MM groups [0 vs (35.0 +/- 14.4)%, P = 0.04]. (2) According to the 3 activating KIR genes: KIR2DS1/ KIR2DS2/ KIR2DS3, lower incidence of grade III-IV aGVHD was seen in KIR2DS1 (+) group than in KIR2DS1 (-) group (13% vs 28%, respectively, P > 0.05); and so was done in KIR2DS3 (+) group (11% vs 26%, respectively, P > 0.05). The RR was lower in KIR2DS2 (+) group [0% vs (17.3 +/- 7.1)%, respectively, P > 0.05].
In our haplo-identical HSCT setting, match between donor's inhibitory KIR and recipient's HLA-C can significantly reduce the incidence of relapse rate and improve OS. Although lower incidences of severe aGVHD are noted in the donors with KIR2DS1 (+) or KIR2DS3 (+), and lower relapse rate is noted in the donors with KIR2DS2 (+) but without statistic difference, no remarkable effects of activating KIRs on OS have been found in our relatively small clinical series.
探讨抑制性和激活性杀伤细胞免疫球蛋白样受体（KIR）对接受单倍型相合造血干细胞移植（HSCT）的中国白血病患者队列的影响。
采用聚合酶链反应-序列特异性引物（PCR-SSP）检测47例接受单倍型相合HSCT患者的供者抑制性和激活性KIR以及受者的HLA-C。分析2年总生存率（OS）、重度（III至IV级）急性移植物抗宿主病（aGVHD）发生率和复发率（RR）。
（1）根据供者抑制性KIR与受者HLA-C1/C2亚组之间的匹配（M）与错配（MM）情况，M组的2年OS率[（87.5±8.3）%]显著高于MM组（54.5±9.0）%，（P = 0.03）。M组的复发率低于M/MM组[0 vs（25.4±9.5）%，P = 0.05]。在30例髓系白血病患者中，M组的RR低于MM组[0 vs（35.0±14.4）%，P = 0.04]。（2）根据3个激活性KIR基因：KIR2DS1/KIR2DS2/KIR2DS3，KIR2DS1（+）组的III-IV级aGVHD发生率低于KIR2DS1（-）组（分别为13% vs 28%，P>0.05）；KIR2DS3（+）组也是如此（分别为11% vs 26%，P>0.05）。KIR2DS2（+）组的RR较低[分别为0% vs（17.3±7.1）%，P>0.05]。
在我们的单倍型相合HSCT情况下，供者抑制性KIR与受者HLA-C之间的匹配可显著降低复发率并改善OS。虽然KIR2DS1（+）或KIR2DS3（+）供者的重度aGVHD发生率较低，KIR2DS2（+）供者的复发率较低，但无统计学差异，但在我们相对较小的临床系列中未发现激活性KIR对OS有显著影响。
