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Allografting

The role of killer immunoglobulin-like receptor haplotypes on the outcome of unrelated donor haematopoietic SCT for thalassaemia

Bone Marrow Transplantation volume 45, pages 1618–1624 (2010)Cite this article

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Abstract

Recent insight into the pathophysiology of acute GVHD after allogeneic haematopoietic SCT has led to a growing interest in the role of natural killer (NK) cells. NK cell cytotoxicity is mainly regulated by the interaction of activating and inhibitory killer immunoglobulin-like receptors (KIRs) with their respective ligands. To investigate the impact of KIRs and their ligands on haematopoietic SCT outcome, we performed a retrospective study of 78 transfusion-dependent thalassaemia patients (median age 10 years, range 1–29 years) transplanted from an unrelated donor selected using high-resolution molecular typing for both class I and II loci after a myeloablative conditioning regimen. GVHD prophylaxis consisted of CsA, short-term MTX and anti-thymocyte globulin in all patients. We found that patients transplanted from donors homozygous for KIR haplotype A had a greater risk of developing grade II–IV acute GVHD compared with those transplanted from a donor carrying at least one B haplotype (hazard ratio=4.5, 99% confidence interval=1.2–17.1, P=0.003). Our study suggests that KIR genotyping of donor and recipient pairs could contribute to the identification of patients at high risk for developing severe complications of haematopoietic SCT and thus may help with the choice of intensity of GVHD prophylaxis.

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Acknowledgements

We thank Anna Maria Koopmans for her assistance in preparing the paper.

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Authors and Affiliations

  1. Centro Regionale Trapianti, Ospedale R. Binaghi—ASL Cagliari, Cagliari, Italy

    R Littera, M Mulargia & C Carcassi

  2. Dipartimento di Scienze Mediche Internistiche, Cattedra di Genetica Medica, Ospedale R. Binaghi, Università di Cagliari, Cagliari, Italy

    N Orrù, S Orrù & C Carcassi

  3. Centro Trapianti Midollo osseo, Ospedale R. Binaghi—ASL Cagliari, Cagliari, Italy

    A Vacca, G Caocci, E Piras & G La Nasa

  4. Oncoematologia Pediatrica, Università di Pavia, Fondazione IRCCS Policlinico S. Matteo, Pavia, Italy

    A Bertaina, A Mastronuzzi, L Vinti & F Locatelli

  5. Unità Operativa di Ematologia, Centro Trapianti di Midollo Osseo di Muraglia, Ospedale S. Salvatore, Pesaro, Italy

    C Giardini

  6. Dipartimento di Scienze Mediche Internistiche, Cattedra di Ematologia, Università di Cagliari, Cagliari, Italy

    G La Nasa

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  1. R Littera
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Correspondence to F Locatelli.

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Littera, R., Orrù, N., Vacca, A. et al. The role of killer immunoglobulin-like receptor haplotypes on the outcome of unrelated donor haematopoietic SCT for thalassaemia. Bone Marrow Transplant 45, 1618–1624 (2010). https://doi.org/10.1038/bmt.2010.24

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