Effect of KIR/HLA receptor-ligand mode on prognosis of single unrelated cord blood transplantation in patients with hematological malignancies.
10.3760/cma.j.issn.0253-2727.2020.03.004
- Author:
Ting Ting FANG
1
;
Xiao Yu ZHU
1
;
Bao Lin TANG
1
;
Hui Lan LIU
1
;
Xiang WAN
1
;
Kai Di SONG
1
;
Wen YAO
1
;
Guang Yu SUN
1
;
Xin Chen FANG
1
;
Zi Min SUN
1
Author Information
1. Department of Hematology, Anhui Provincial Hospital of Anhui Medical University, Hefei 230001, China.
- Publication Type:Journal Article
- Keywords:
Human leukocyte antigen;
KIR ligands absence;
Natural killercell immunoglobulin-like receptors;
Umbilical cord blood transplantation
- MeSH:
Adolescent;
Adult;
Child;
Child, Preschool;
Cord Blood Stem Cell Transplantation;
Female;
Graft vs Host Disease;
HLA Antigens;
Hematologic Neoplasms/therapy*;
Hematopoietic Stem Cell Transplantation;
Humans;
Infant;
Male;
Middle Aged;
Neoplasm Recurrence, Local;
Receptors, KIR;
Retrospective Studies;
Young Adult
- From:
Chinese Journal of Hematology
2020;41(3):204-209
- CountryChina
- Language:Chinese
-
Abstract:
Objective: To explore the impact of the natural killer cell immunoglobulin-like receptor/human leukocyte antigen (KIR/HLA) receptor-ligand model in single unrelated cord blood transplantation (sUCBT) . Methods: Between July 2012 and June 2018, 270 patients with malignant hematologic diseases receiving single-unit UCBT were divided into two groups. Group 1 (n=174) patients lacked a C-ligand for inhibitory KIR on UCB NK cells (patients homozygous C1/C1 or C2/C2) . Group 2 (n=96) patients expressed both C ligands for inhibitory KIR in the receptor (patients heterozygous C1/C2) . Results: A total of 270 patients (146 males, 124 females) with a median age of 13 years (1-62) were included in this retrospective study. All patients received a myeloablative conditioning regimen (without ATG) . The ratio of neutrophil engraftment for group 1 and 2 were both 98.9%, the median time of neutrophil engraftment for group 1 and 2 was 16 (10-41) days vs 17 (11-33) days (P=0.705) . The ratio of platelet engraftment was 88.5% for group 1 and 87.5% for group 2, the median time of platelet engraftment was 35 (11-113) days vs 38.5 (13-96) days (P=0.317) . The cumulative incidence of Ⅱ-Ⅳ acute GVHD in 100 days was 38.7% (95%CI 31.4%-45.9%) for group 1 and 50.0% (95%CI 39.6%-59.6%) for group 2 (P=0.075) , but multivariate analysis showed that HLA-C ligand absence was an independent protective factor for Ⅱ-Ⅳ acute GVHD after transplantation (P=0.036) . Patients in absence of a C-ligand for inhibitory KIRs (Group 1) showed a lower relapse rate than patients with both C-ligands (group 2) : 17.7% (95%CI 11.7%-24.9%) vs 22.7% (95%CI 4.4%-32.2%) after 3 years (P=0.288) . The median follow-up time was 742 (335-2 512) days. The 3-year OS was 72.1% for group 1 and 60.5% for group 2 (P=0.079) . There was no statistically significant difference between the two groups in 3-year disease-free survival [64.9% (95%CI 56.2%-72.3%) vs 55.4% (95%CI 44.4%-65.0%) (χ(2)=3.027, P=0.082) ]. Non-relapse mortality for group 1 was 12.1% (95%CI 7.7%-17.4%) and for group 2 was 16.7% (95%CI 10.0%-24.8%) (P=0.328) . Conclusion: Patients lacking a KIR-ligand of HLA group C1 or C2 had a lower incidence of grades Ⅱ-Ⅳ acute GVHD after sUCBT.
