The effect of KIR ligand incompatibility on the outcome of unrelated donor transplantation: A report from the Center for International Blood and Marrow Transplant Research, the European Blood and Marrow Transplant Registry, and the Dutch Registry Journal Article
| Authors: | Farag, S. S.; Bacigalupo, A.; Eapen, M.; Hurley, C.; Dupont, B.; Caligiuri, M. A.; Boudreau, C.; Nelson, G.; Oudshoorn, M.; Van Rood, J.; Velardi, A.; Maiers, M.; Setterholm, M.; Confer, D.; Posch, P. E.; Anasetti, C.; Kamani, N.; Miller, J. S.; Weisdorf, D.; Davies, S. M. |
| Article Title: | The effect of KIR ligand incompatibility on the outcome of unrelated donor transplantation: A report from the Center for International Blood and Marrow Transplant Research, the European Blood and Marrow Transplant Registry, and the Dutch Registry |
| Abstract: | Matching for HLA class I alleles, including HLA-C, is an important criterion for outcome of unrelated donor transplantation. However, haplotype-mismatched transplantations for myeloid malignancies, mismatched for killer immunoglobulin-like receptor (KIR) ligands in the graft-versus-host (GVH) direction, is associated with lower rates of graft-versus-host disease (GVHD), relapse, and mortality. This study investigated the effect of KIR ligand mismatching on the outcome of unrelated donor transplantation. The outcomes after 1571 unrelated donor transplantations for myeloid malignancies where donor-recipient pairs were HLA-A, -B, -C, and -DRB1 matched (n = 1004), GVH KIR ligand-mismatched (n = 137), host-versus-graft (HVG) KIR ligand-mismatched (n = 170), and HLA-B and/or -C-mismatched but KIR ligand-matched (n = 260) were compared using Cox regression models. Treatment-related mortality (TRM), treatment failure, and overall mortality were lowest after matched transplantations. Patients who received grafts from donors mismatched at the KIR ligand in the GVH or HVG direction and mismatched at HLA-B and/or C but matched at the KIR ligand had similar rates of TRM, treatment failure, and overall mortality. There were no differences in leukemia recurrence between the 4 groups. These results do not support the choice of an unrelated donor on the basis of KIR ligand mismatch determined from HLA typing. © 2006 American Society for Blood and Marrow Transplantation. |
| Keywords: | adolescent; adult; cancer survival; child; controlled study; treatment outcome; aged; disease-free survival; middle aged; leukemia; survival rate; treatment failure; retrospective studies; transplantation, homologous; acute granulocytic leukemia; major clinical study; overall survival; busulfan; cancer recurrence; patient selection; medical decision making; allele; disease association; cyclophosphamide; chronic myeloid leukemia; cancer mortality; haplotype; europe; netherlands; hematologic malignancy; hla matching; myelodysplastic syndrome; whole body radiation; donor; hematologic neoplasms; registries; tissue donors; proportional hazards model; medical research; hla dr antigen; hla antigen class 1; graft versus host reaction; ligands; cancer relapse; killer cell immunoglobulin like receptor; receptors, kir; graft rejection; hla a antigen; hla b antigen; hla c antigen; bone marrow transplantation; hla typing; graft vs host disease; hla antigens; lymphocyte depletion; receptors, immunologic; recipient; refractory anemia; unrelated donor; histocompatibility testing; histoincompatibility; refractory anemia with excess blasts; kir ligand incompatibility |
| Journal Title: | Biology of Blood and Marrow Transplantation |
| Volume: | 12 |
| Issue: | 8 |
| ISSN: | 1083-8791 |
| Publisher: | Elsevier Inc. |
| Date Published: | 2006-08-01 |
| Start Page: | 876 |
| End Page: | 884 |
| Language: | English |
| DOI: | 10.1016/j.bbmt.2006.05.007 |
| PUBMED: | 16864058 |
| PROVIDER: | scopus |
| DOI/URL: | |
| Notes: | --- - "Cited By (since 1996): 91" - "Export Date: 4 June 2012" - "CODEN: BBMTF" - "Source: Scopus" |
