The impact of donor human leukocyte antigen-Bw4 allele on natural killer cell reconstitution and transplant-related mortality in haploidentical transplantation
10.3760/cma.j.cn.121090-20240314-00094
- VernacularTitle:单倍体造血干细胞移植模式下供者HLA-Bw4对移植后NK细胞重建及移植相关死亡风险的影响
- Author:
Ming ZHAO
1
;
Zhengli XU
;
Xingxing YU
;
Yiyang DING
;
Yingjun CHANG
;
Xiaohui ZHANG
;
Kaiyan LIU
;
Xiaojun HUANG
;
Xiangyu ZHAO
Author Information
1. 北京大学人民医院、北京大学血液病研究所、国家血液系统疾病临床医学研究中心，北京市造血干细胞移植治疗血液病重点实验室，北京 100044
- Keywords:
HLA-Bw4;
NK reconstitution;
PT-Cy;
Transplantation-related mortality
- From:
Chinese Journal of Hematology
2024;45(5):453-461
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the impact of donor human leukocyte antigen (HLA) -Bw4 expression on natural killer (NK) cell reconstitution and transplant outcomes in recipients undergoing haploidentical hematopoietic stem cell transplantation (HSCT) from maternal or related donors without ex vivo T-cell depletion.Methods:This study prospectively enrolled 32 patients who received T-replete haploidentical HSCT from maternal or collateral donors (cohort 1) to evaluate the facilitating effect of donor HLA-Bw4 expression on NK cell reconstitution. Furthermore, a retrospective analysis was conducted on 278 patients who underwent T-replete haploidentical HSCT from maternal or collateral donors (cohort 2) to analyze the impact of donor HLA-Bw4 expression on HSCT outcomes. Thus, a comparison was made between the effects of donor HLA-Bw4 expression on HSCT outcomes in patients receiving or not receiving post-transplant cyclophosphamide (PT-Cy) conditioning.Results:Donors expressing HLA-Bw4 alleles facilitated NK cell reconstitution and functional recovery, which remained unaffected by PT-Cy. Donors with HLA-Bw4 expression were associated with reduced transplant-related mortality (TRM), particularly mortality related to infections. The use of PT-Cy did not impact the ability of donor HLA-Bw4 to decrease TRM.Conclusion:In haploidentical HSCT from maternal or related donors without ex vivo T-cell depletion, the presence of donor HLA-Bw4 expression promotes rapid NK cell reconstitution and functional recovery and is significantly associated with lower TRM, especially infection-related mortality. These findings underscore the clinical significance of donor HLA-Bw4 expression in patients who underwent HSCT. Hence, the consideration of donor HLA-Bw4 in recipient selection and HSCT strategies holds important clinical implications.
