KIR haplotype B donors but not KIR-ligand mismatch result in a reduced incidence of relapse after haploidentical transplantation using reduced intensity conditioning and CD3/CD19-depleted grafts

Ann Hematol. 2014 Sep;93(9):1579-86. doi: 10.1007/s00277-014-2084-2. Epub 2014 Apr 26.

Abstract

Natural killer (NK)-cell alloreactivity after allogeneic hematopoietic cell transplantation (HCT) is influenced by the interaction of killer-cell immunoglobulin-like receptors (KIRs) on donor NK cells and human leukocyte antigen (HLA) class I ligands on recipient cells. We investigated the influence of donor KIR haplotype and KIR-ligand mismatch (MM) on relapse in 57 patients with hematologic malignancies receiving haploidentical HCT after reduced intensity conditioning and graft CD3/CD19 depletion. Of the 57 donors, 17 had KIR haplotype A (29.8 %) and 40 had KIR haplotype B (70.2 %). A KIR-ligand MM was found in 34 of 57 patients (59.6 %). There was no difference between donor KIR haplotypes in non-relapse mortality (NRM, p = 0.200) but had a significantly reduced incidence of relapse for patients with a haplotype B donor (p = 0.001). In particular, patients in partial remission (PR) benefited more from a haplotype B graft (p = 0.008) than patients in complete remission (CR, p = 0.297). Evaluating KIR-ligand MM cumulative incidences of relapse (p = 0.680) or NRM (p = 0.579), we found no significant difference. In conclusion, in the setting of reduced intensity conditioning (RIC) and CD3/CD19-depleted haploidentical HCT, we could not confirm the positive data with KIR-ligand MM but observed a significant lower risk of relapse with a KIR haplotype B donor.

Publication types

  • Clinical Trial, Phase II
  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Antigens, CD19 / genetics
  • Antigens, CD19 / metabolism
  • Blood Group Incompatibility / complications
  • Blood Group Incompatibility / genetics
  • CD3 Complex / genetics
  • CD3 Complex / metabolism
  • Cell Separation
  • Female
  • Haplotypes
  • Hematologic Neoplasms / genetics
  • Hematologic Neoplasms / surgery*
  • Hematopoietic Stem Cell Transplantation / adverse effects
  • Hematopoietic Stem Cells / cytology*
  • Hematopoietic Stem Cells / immunology
  • Hematopoietic Stem Cells / metabolism
  • Histocompatibility Antigens Class I / genetics*
  • Histocompatibility Testing
  • Humans
  • Incidence
  • Male
  • Middle Aged
  • Receptors, KIR / genetics*
  • Recurrence
  • Transplantation Conditioning / adverse effects
  • Transplantation Conditioning / methods
  • Transplantation, Homologous
  • Young Adult

Substances

  • Antigens, CD19
  • CD3 Complex
  • Histocompatibility Antigens Class I
  • Receptors, KIR