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Immune Recovery

Effect of missing killer-immunoglobulin-like receptor ligand in recipients undergoing HLA full matched, non-T-depleted sibling donor transplantation: a single institution experience of 151 Asian patients

Bone Marrow Transplantation volume 45, pages 1031–1037 (2010)Cite this article

Abstract

This retrospective analysis studied the impact of natural killer (NK) alloreactivity based on the missing ligand model, for a cohort of recipients undergoing haemopoietic stem cell transplant without T-cell depletion from HLA full-matched sibling donors. All patients received a uniform myeloablative conditioning regimen and prophylaxis for GVHD. A total of 151 patients were studied, including 62 patients with AML or myelodysplastic syndrome, 42 patients with ALL and 47 patients with CML. We found that 81% of patients had at least one missing KIR-ligand (KIR-L), and HLA-C1 allogroup homozygosity is present in 70% of patients. From multivariate analysis, we observed that the only consistently significant factor that was associated with superior survival was disease stage. Missing KIR-L, whether considering HLA-Bw and HLA-C alleles, without or with HLA-A ligands or narrowing to only HLA-C alleles alone to classify the number of missing KIR-L, did not have any impact on OS or relapse-free survival. This negative finding implies that as the KIR-L composition of recipient is not important in this matched non-T-depleted setting, further immunotherapeutic measures involving adoptive NK cell infusions have to be explored to exploit the benefit of NK alloreactivity for such transplants.

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Acknowledgements

We thank Ms Joan Seet (HLA laboratory), Dr Perumal Premalatha and Ms Zhang Xuehui (Haematology Research) for their assistance in the provision of data. We also express our gratitude to all nursing and paramedical staff in the Department of Haematology for their contribution towards the transplant program. This project is supported by a grant from the SingHealth Research Foundation SRF#113/05.

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Authors and Affiliations

  1. Department of Haematology, Singapore General Hospital, Singapore

    Y C Linn, K K Heng, J J Lee, Y Loh, W Hwang, Y T Goh & M Koh

  2. Blood Services Group, Health Sciences Authority, Singapore

    C Y Phang, T J Lim & M Koh

  3. Department of Clinical Research, Singapore General Hospital, Singapore

    S F Chong

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  1. Y C Linn
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Correspondence to Y C Linn.

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Linn, Y., Phang, C., Lim, T. et al. Effect of missing killer-immunoglobulin-like receptor ligand in recipients undergoing HLA full matched, non-T-depleted sibling donor transplantation: a single institution experience of 151 Asian patients. Bone Marrow Transplant 45, 1031–1037 (2010). https://doi.org/10.1038/bmt.2009.303

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