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Acute Leukemias

Effects of activating NK cell receptor expression and NK cell reconstitution on the outcomes of unrelated donor hematopoietic cell transplantation for hematologic malignancies

Leukemia volume 23, pages 1278–1287 (2009)Cite this article

Abstract

Inhibitory NK cell receptors are recognized as important determinants of NK cell activity in hematopoietic cell transplantation (HCT). The role of activating receptors and their acquisition after HCT is less certain. Therefore, we comprehensively evaluated both inhibitory and activating receptors in 59 patients receiving unrelated donor HCT. NK cell numbers normalized quickly relative to B and T cells; however, the expression of both inhibitory and activating isoforms of killer immunoglobulin-like receptors (KIRs) was delayed. Most NK cells expressed an immature phenotype during the first 6 months post-HCT; however, we found high expression of activating NKp46 and NKp44 natural cytotoxicity receptors (NCRs), and cytotoxicity was preserved. Early reconstituting NK cells from unmanipulated grafts showed lower cytotoxicity than those from T-cell-depleted grafts. Differences in NK cell reconstitution had significant effects on clinical outcomes. Patients whose NK cells reconstituted earlier had better survival and lower relapse rates. The best survival group was recipients who possessed HLA-C2 but their donor lacked the cognate-activating KIR2DS1. Collectively, our data underscore the clinical relevance of reconstituting NK cells and their activating KIRs and NCRs. In addition to NK cell quantification and genotyping, comprehensive assessment of NK cell functions and phenotypes, including activating receptors, is essential.

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Acknowledgements

We thank the NMDP for providing pretransplant banked patient and donor samples. We also thank Thasia Leming, Xioahua Chen and James Knowles for their technical assistance. This study was funded in part by Cancer Center Support (CORE) Grant CA21765, by the Assisi Foundation of Memphis and by the American Lebanese Syrian Associated Charities (ALSAC). The funding sources had no role in data collection, data analysis, data interpretation or writing of the report.

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  1. B M Triplett and E M Horwitz: These two authors contributed equally to this work.

Authors and Affiliations

  1. Division of Hematology and Oncology, Department of Pediatrics, Saint Louis University, Saint Louis, MO, USA

    B M Triplett

  2. Division of Oncology, Department of Pediatrics, The Children's Hospital of Philadelphia, Philadelphia, PA, USA

    E M Horwitz

  3. Department of Oncology, St Jude Children's Research Hospital, Memphis, TN, USA

    R Iyengar, M S Holladay, K Gan & W Leung

  4. Department of Pathology, St Jude Children's Research Hospital, Memphis, TN, USA

    V Turner

  5. Department of Pathology, University of Chicago, Chicago, IL, USA

    F G Behm

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  1. B M Triplett
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Correspondence to B M Triplett.

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All work was carried out at St Jude Children's Research Hospital.

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Triplett, B., Horwitz, E., Iyengar, R. et al. Effects of activating NK cell receptor expression and NK cell reconstitution on the outcomes of unrelated donor hematopoietic cell transplantation for hematologic malignancies. Leukemia 23, 1278–1287 (2009). https://doi.org/10.1038/leu.2009.21

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