Killer Cell Immunoglobulin-Like Receptor-Ligand Matching and Outcomes after Unrelated Cord Blood Transplantation in Acute Myeloid Leukemia

Vanderson Rocha, Annalisa Ruggeri, Stephen Spellman, Tao Wang, Ronald Sobecks, Franco Locatelli, Medhat Askar, Gerard Michel, William Arcese, Anna Paola Iori, Duncan Purtill, Robert Danby, Guillermo F. Sanz, Eliane Gluckman, Mary Eapen

Research output: Contribution to journalArticle

Abstract

The effect of killer cell immunoglobulin-like receptor (KIR)-ligand matching on outcomes after unrelated cord blood (CB) transplantation was studied in 461 patients with acute myeloid leukemia, categorizing KIR ligand for HLA-C groups C1 and C2 and Bw4. Donor-recipient HLA matching considered allele-level matching at HLA-A, -B, -C, and -DRB1. Separate analyses were conducted for 6-7/8 HLA-matched and 3-5/8 HLA-matched transplants because HLA matching confounded KIR-ligand matching (ie, KIR-ligand mismatching was less likely with better HLA matching). All patients received single CB unit and myeloablative conditioning. There were no significant differences in nonrelapse mortality (NRM), relapse, and overall mortality by KIR-ligand match status. However, among recipients of 3-5/8 HLA-matched transplants, NRM (HR, 2.26; P = .008) and overall mortality (HR, 1.78; P = .008) but not relapse were higher with KIR-ligand mismatched (host-versus-graft direction) compared with KIR-ligand matched transplants. These data do not support selecting CB units based on KIR-ligand match status for transplants mismatched at 1 or 2 HLA loci. Although transplants mismatched at 3 or more HLA loci are not recommended, avoiding KIR-ligand mismatching in this setting lowers mortality risks.

Original languageEnglish
Pages (from-to)1284-1289
Number of pages6
JournalBiology of Blood and Marrow Transplantation
Volume22
Issue number7
DOIs
Publication statusPublished - Jul 1 2016

    Fingerprint

Keywords

  • Acute leukemia
  • Cord blood
  • KIR ligand
  • Unrelated transplant

ASJC Scopus subject areas

  • Transplantation
  • Hematology

Cite this

Rocha, V., Ruggeri, A., Spellman, S., Wang, T., Sobecks, R., Locatelli, F., Askar, M., Michel, G., Arcese, W., Iori, A. P., Purtill, D., Danby, R., Sanz, G. F., Gluckman, E., & Eapen, M. (2016). Killer Cell Immunoglobulin-Like Receptor-Ligand Matching and Outcomes after Unrelated Cord Blood Transplantation in Acute Myeloid Leukemia. Biology of Blood and Marrow Transplantation, 22(7), 1284-1289. https://doi.org/10.1016/j.bbmt.2016.04.007