Department of Haematology, Yantai Yu Hunag Ding Hospital, Yantai, China.
Swiss Med Wkly. 2013 Jan 8;143:w13717. doi: 10.4414/smw.2013.13717. eCollection 2013.
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.
The purpose of the study was to analyse the impact of interaction between recipient HLA-Cw and donor KIR on outcome.
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.
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).
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.
自然杀伤细胞和某些 T 淋巴细胞亚群的同种异体反应受供体细胞中杀伤免疫球蛋白样受体（KIR）与靶细胞上人类白细胞抗原（HLA）-I 类分子之间相互作用的调节。已证明这种相互作用会影响异基因造血干细胞移植（HSCT）的结果。通过 HLA-Cw 分型将纯合子 C1 或 C2 和杂合子 C1/C2 进行划分，它们会影响 HSCT 的结果。
本研究旨在分析受者 HLA-Cw 与供者 KIR 相互作用对结果的影响。
将受者 HLA-Cw 配体和供者 KIR 的基因型与 52 例接受 HLA 匹配的同胞供体 HSCT 治疗骨髓恶性肿瘤的患者的临床结果相关联。
C1 或 C2 纯合子患者的慢性移植物抗宿主病（GVHD）发生率明显低于 C1/C2 杂合子（p = 0.000）。C1 或 C2 纯合子患者的总生存率（OS）和无病生存率（DFS）均高于 C1/C2 杂合子（OS，81%±8% vs 54%±10%，p = 0.034；DFS，81%±8% vs 54%±10%，p = 0.024）。HLA-KIR 不匹配组的慢性 GVHD 发生率较低，OS 和 DFS 较高（慢性 GVHD，p = 0.007；OS，84%±7% vs 47%±13%，p = 0.003；DFS，84%±7% vs 47%±13%，p = 0.002）。
受者 HLA 配体与供者 KIR 之间的相互作用对接受匹配同胞 HSCT 的患者的结果有显著影响。C1/C2 杂合子或 HLA-KIR 匹配的患者可能受益于额外的强化治疗，从而获得更好的结果。
