The Effect of KIR Ligand Incompatibility on the Outcome of Unrelated Donor Transplantation: A Report from the Center for International Blood and Marrow Transplant Research, the European Blood and Marrow Transplant Registry, and the Dutch Registry

Sherif S. Farag, Andrea Bacigalupo, Mary Eapen, Carolyn Hurley, Bo Dupont, Michael A. Caligiuri, Christian Boudreau, Gene Nelson, Machteld Oudshoorn, Jon van Rood, Andrea Velardi, Martin Maiers, Michelle Setterholm, Dennis Confer, Phillip E. Posch, Claudio Anasetti, Naynesh Kamani, Jeffrey S. Miller, Daniel Weisdorf, Stella M. Davies

Research output: Contribution to journalArticle

186 Scopus citations

Abstract

Matching for HLA class I alleles, including HLA-C, is an important criterion for outcome of unrelated donor transplantation. However, haplotype-mismatched transplantations for myeloid malignancies, mismatched for killer immunoglobulin-like receptor (KIR) ligands in the graft-versus-host (GVH) direction, is associated with lower rates of graft-versus-host disease (GVHD), relapse, and mortality. This study investigated the effect of KIR ligand mismatching on the outcome of unrelated donor transplantation. The outcomes after 1571 unrelated donor transplantations for myeloid malignancies where donor-recipient pairs were HLA-A, -B, -C, and -DRB1 matched (n = 1004), GVH KIR ligand-mismatched (n = 137), host-versus-graft (HVG) KIR ligand-mismatched (n = 170), and HLA-B and/or -C-mismatched but KIR ligand-matched (n = 260) were compared using Cox regression models. Treatment-related mortality (TRM), treatment failure, and overall mortality were lowest after matched transplantations. Patients who received grafts from donors mismatched at the KIR ligand in the GVH or HVG direction and mismatched at HLA-B and/or C but matched at the KIR ligand had similar rates of TRM, treatment failure, and overall mortality. There were no differences in leukemia recurrence between the 4 groups. These results do not support the choice of an unrelated donor on the basis of KIR ligand mismatch determined from HLA typing.

Original languageEnglish (US)
Pages (from-to)876-884
Number of pages9
JournalBiology of Blood and Marrow Transplantation
Volume12
Issue number8
DOIs
StatePublished - Aug 1 2006
Externally publishedYes

Keywords

  • Bone marrow transplantation
  • KIR ligand incompatibility
  • Leukemia
  • Unrelated donor

ASJC Scopus subject areas

  • Hematology
  • Transplantation

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  • Cite this

    Farag, S. S., Bacigalupo, A., Eapen, M., Hurley, C., Dupont, B., Caligiuri, M. A., Boudreau, C., Nelson, G., Oudshoorn, M., van Rood, J., Velardi, A., Maiers, M., Setterholm, M., Confer, D., Posch, P. E., Anasetti, C., Kamani, N., Miller, J. S., Weisdorf, D., & Davies, S. M. (2006). The Effect of KIR Ligand Incompatibility on the Outcome of Unrelated Donor Transplantation: A Report from the Center for International Blood and Marrow Transplant Research, the European Blood and Marrow Transplant Registry, and the Dutch Registry. Biology of Blood and Marrow Transplantation, 12(8), 876-884. https://doi.org/10.1016/j.bbmt.2006.05.007