Fang Xinchen, Zhu Xiaoyu, Tang Baolin, Song Kaidi, Yao Wen, Wan Xiang, Liu Huilan, Peng Jun, Sun Zimin
Department of Hematology, Qilu Hospital, Cheeloo College of Medicine, Shandong University, No. 27 Shanda South Road, Jinan, Shandong, 250012, China.
Department of Hematology, The First Affiliated Hospital of University of Science and Technology of China, Hefei, Anhui, 230001, China.
Mediterr J Hematol Infect Dis. 2021 Jan 1;13(1):e2021005. doi: 10.4084/MJHID.2021.005. eCollection 2021.
Donor natural killer (NK) cell alloreactivity in umbilical cord bone marrow transplantation (UCBT) can lead to leukemic relapse. However, NK cell function is calibrated by interaction with human leukocyte antigens (HLAs). This study aimed to investigate graft-resistant leukemia after transplantation and compared specific genotypes of killer immunoglobulin-like receptors (KIRs) in donors and human leukocyte antigen ligands in patients.
We retrospectively analyzed 232 patients with acute leukemia from a single center. Patients had undergone UCBT with myeloablative conditioning and without anti-thymocyte globulin. We identified the KIR genotypes of cord blood donors using polymerase chain reaction with sequence-specific primers. All of the donors contained KIR3DL1.
The patients were divided into three groups according to the HLA-B locus. The donor KIR3DL1 and recipient HLA-Bw4-80I combination was predictive of being highly educated and was associated with a lower relapse (=0.006) and better overall survival (probability of relapse=0.13, < 0.001) than the uneducated group. We found no significant increase in the incidence of acute or chronic graft-versus-host disease.
Our data suggest that the donor KIR3DL1/receptor and HLA-Bw4-80I combination in UCBT results in stronger graft-versus-leukemia effects and improved outcomes in patients with acute leukemia.
脐带血骨髓移植（UCBT）中供体自然杀伤（NK）细胞的同种异体反应性可导致白血病复发。然而，NK细胞功能通过与人类白细胞抗原（HLA）相互作用进行校准。本研究旨在调查移植后抗移植物白血病情况，并比较供体中杀伤细胞免疫球蛋白样受体（KIR）的特定基因型与患者中人类白细胞抗原配体情况。
我们回顾性分析了来自单一中心的232例急性白血病患者。患者接受了清髓性预处理且未使用抗胸腺细胞球蛋白的UCBT。我们使用序列特异性引物聚合酶链反应鉴定脐血供体的KIR基因型。所有供体均含有KIR3DL1。
根据HLA - B位点将患者分为三组。供体KIR3DL1与受体HLA - Bw4 - 80I组合预示着受教育程度高，与未接受该组合的组相比，复发率较低（=0.006），总生存率更高（复发概率=0.13，<0.001）。我们发现急性或慢性移植物抗宿主病的发生率没有显著增加。
我们的数据表明，UCBT中供体KIR3DL1/受体与HLA - Bw4 - 8
