The impact of donor full-length KIR2DS4 in the development of acute and chronic GVHD after unrelated allogeneic HSCT.
Acute Disease
Adolescent
Alleles
Child
Child, Preschool
China
Cytomegalovirus
Disease-Free Survival
Female
Genotype
Graft vs Host Disease
/ etiology
HLA Antigens
/ genetics
Haplotypes
Hematologic Neoplasms
/ genetics
Hematopoietic Stem Cell Transplantation
/ methods
Humans
Incidence
Leukemia, Myelogenous, Chronic, BCR-ABL Positive
/ immunology
Leukemia, Myeloid, Acute
/ immunology
Leukemia, Myelomonocytic, Juvenile
/ immunology
Male
Myelodysplastic Syndromes
/ immunology
Neoplasm Recurrence, Local
Precursor Cell Lymphoblastic Leukemia-Lymphoma
/ immunology
Receptors, KIR
/ genetics
Recurrence
Treatment Outcome
KIR2DS4
NK cell
acute GVHD
allogeneic hematopoietic SCT
chronic GVHD
Journal
Pediatric transplantation
ISSN: 1399-3046
Titre abrégé: Pediatr Transplant
Pays: Denmark
ID NLM: 9802574
Informations de publication
Date de publication:
09 2020
09 2020
Historique:
received:
17
07
2019
revised:
05
03
2020
accepted:
13
04
2020
pubmed:
1
7
2020
medline:
31
8
2021
entrez:
29
6
2020
Statut:
ppublish
Résumé
Killer Ig-like receptor 2DS4 (KIR2DS4) is the most prevalent activating killer Ig-like receptor gene. It is divergent and encodes either full-length or deleted allele variants. The studies of donor killer KIR2DS4 in unrelated allogeneic hematopoietic stem cell transplantations were limited. KIR and HLA genotyping were determined in 75 pairs of Chinese pediatric hematologic malignancy patients. Among the 75 donor-recipient pairs, 77.3% (58/75) of the donors were positive for full-length KIR2DS4 and 22.7% (17/75) were negative. Patients who had donors positive for full-length KIR2DS4 had higher cumulative incidence of aGVHD than patients whose donor negative for full-length KIR2DS4 (86.2% versus 76.5%, P = .038). Multivariate analysis showed full-length KIR2DS4 was the significant factor for I-IV aGVHD (HR = 2.166, 95% CI: 1.01-4.26, P = .025). Subgroup analysis showed that AML and CML patients who received donors negative for full-length KIR2DS4 have a higher cumulative incidences of cGVHD (75% vs 62%, P = .008). There were no significant effects of full-length KIR2DS4 on overall survival (P = .13), relapse-free survival (P = .14), CMV reactivation (P = .52), and relapse (HR = 0.38, 95% CI: 0.09-1.6, P = .1875). Our findings indicated a significant correlation of donor full-length KIR2DS4 on aGVHD and cGVHD. These results suggested that combining KIR and HLA genotyping may help make a better sense of transplants in these patients.
Sections du résumé
BACKGROUND
Killer Ig-like receptor 2DS4 (KIR2DS4) is the most prevalent activating killer Ig-like receptor gene. It is divergent and encodes either full-length or deleted allele variants. The studies of donor killer KIR2DS4 in unrelated allogeneic hematopoietic stem cell transplantations were limited.
METHODS
KIR and HLA genotyping were determined in 75 pairs of Chinese pediatric hematologic malignancy patients.
RESULTS
Among the 75 donor-recipient pairs, 77.3% (58/75) of the donors were positive for full-length KIR2DS4 and 22.7% (17/75) were negative. Patients who had donors positive for full-length KIR2DS4 had higher cumulative incidence of aGVHD than patients whose donor negative for full-length KIR2DS4 (86.2% versus 76.5%, P = .038). Multivariate analysis showed full-length KIR2DS4 was the significant factor for I-IV aGVHD (HR = 2.166, 95% CI: 1.01-4.26, P = .025). Subgroup analysis showed that AML and CML patients who received donors negative for full-length KIR2DS4 have a higher cumulative incidences of cGVHD (75% vs 62%, P = .008). There were no significant effects of full-length KIR2DS4 on overall survival (P = .13), relapse-free survival (P = .14), CMV reactivation (P = .52), and relapse (HR = 0.38, 95% CI: 0.09-1.6, P = .1875).
CONCLUSIONS
Our findings indicated a significant correlation of donor full-length KIR2DS4 on aGVHD and cGVHD. These results suggested that combining KIR and HLA genotyping may help make a better sense of transplants in these patients.
Substances chimiques
HLA Antigens
0
KIR2DS4 protein, human
0
Receptors, KIR
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
e13728Informations de copyright
© 2020 Wiley Periodicals LLC.
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