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Title: KIR-ligand incompatibility in the graft-versus-host direction improves outcomes after umbilical cord blood transplantation for acute leukemia
Authors: Willemze, R ×
Rodrigues, C A
Labopin, M
Sanz, G
Michel, G
Socié, G
Rio, B
Sirvent, A
Renaud, M
Madero, L
Mohty, M
Ferra, C
Garnier, F
Loiseau, P
Garcia, J
Lecchi, L
Kögler, G
Beguin, Y
Navarrete, C
Devos, Timothy
Ionescu, I
Boudjedir, K
Herr, A-L
Gluckman, E
Rocha, V
Eurocord-Netcord and Acute Leukaemia Working Party of the EBMT #
Issue Date: Mar-2009
Publisher: Nature Publishing Group
Series Title: Leukemia vol:23 issue:3 pages:492-500
Abstract: Donor killer cell immunoglobulin-like receptor (KIR)-ligand incompatibility is associated with decreased relapse incidence (RI) and improved leukemia-free survival (LFS) after haploidentical and HLA-mismatched unrelated hematopoietic stem cell transplantation. We assessed outcomes of 218 patients with acute myeloid leukemia (AML n=94) or acute lymphoblastic leukemia (n=124) in complete remission (CR) who had received a single-unit unrelated cord blood transplant (UCBT) from a KIR-ligand-compatible or -incompatible donor. Grafts were HLA-A, -B or -DRB1 matched (n=21) or mismatched (n=197). Patients and donors were categorized according to their degree of KIR-ligand compatibility in the graft-versus-host direction by determining whether or not they expressed HLA-C group 1 or 2, HLA-Bw4 or HLA-A3/-A11. Both HLA-C/-B KIR-ligand- and HLA-A-A3/-A11 KIR-ligand-incompatible UCBT showed a trend to improved LFS (P=0.09 and P=0.13, respectively). Sixty-nine donor-patient pairs were HLA-A, -B or -C KIR-ligand incompatible and 149 compatible. KIR-ligand-incompatible UCBT showed improved LFS (hazards ratio=2.05, P=0.0016) and overall survival (OS) (hazards ratio=2.0, P=0.004) and decreased RI (hazards ratio=0.53, P=0.05). These results were more evident for AML transplant recipients (2-year LFS and RI with or without KIR-ligand incompatibility 73 versus 38% (P=0.012), and 5 versus 36% (P=0.005), respectively). UCBT for acute leukemia in CR from KIR-ligand-incompatible donors is associated with decreased RI and improved LFS and OS.
URI: 
ISSN: 0887-6924
Publication status: published
KU Leuven publication type: IT
Appears in Collections:Laboratory of Experimental Transplantation
× corresponding author
# (joint) last author

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