NK-KIR基因库和非亲属异基因造血细胞移植后急性髓性白血病患者的预后

W. Chainonthee, M. Bornhäuser, M. Füssel, G. Ehninger, R. Wassmuth
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摘要

在这项回顾性研究中,系统地调查了150例接受非亲属供体同种异体造血细胞移植(HCT)的急性髓系白血病(AML)患者,供体和受体的kirr基因含量及其各自的配体,包括临床参数作为潜在的混杂变量对结果的影响。KIR配体错配和供体/受体KIR单倍型组合对总生存期(OS)、无病生存期(DSF)、非复发死亡率(NRM)和复发无显著影响。分离的KIR单倍型对急性、慢性移植物抗宿主病(aGvHD和cGvHD)以及非复发死亡率和复发的累积发生率有影响。在KIR - AA纯合子的供体和再受体配对中评估非复发死亡率(AA/Bx: p=0.038, HR=0.73, 95% CI=0.35-1.46, AA/AA: p=0.043, HR=0.64, 95% CI 0.53-1-17)。我们的数据表明,KIR基因分型可能对可以确定几个HLA相同的非亲属供体的患者有用,但可能不是主要供体选择算法所必需的。
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NK-KIR Gene Repertoire and Outcome of Patients with Acute MyeloidLeukemia after Allogeneic Hematopoietic Cell Transplantation from UnrelatedDonors
In this retrospective study, the influence of donor and recipient KIR-gene content and their respective ligands including clinical parameters as potential confounding variables on the outcome of 150 acute myeloid leukemia (AML) patients undergoing allogenic hematopoietic cell transplantation (HCT) from unrelated donors was systematically investi- gated. There was no significant influence of KIR ligand mismatching and of donor/recipient KIR haplotype combinations on overall survival (OS), disease free survival (DSF), non-relapse mortality (NRM) and relapse. Isolated effects of KIR haplotypes, were detected for acute, chronic Graft versus Host Disease (aGvHD and cGvHD) as well as for the cumula- tive incidence of non-relapse mortality and relapse. The incidence of non-relapse mortality was evaluated in donor and re- cipient pairs harbouring KIR AA homozygosity (AA/Bx: p=0.038, HR=0.73, 95% CI=0.35-1.46 and AA/AA: p=0.043, HR=0.64, 95% CI 0.53-1-17). Our data suggest that KIR genotyping may be useful in patients in whom several HLA- identical unrelated donors can be identified but is probably not necessary for the primary donor selection algorithm.
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