Decreased iKIR-HLA C Pair Confers Worse Clinical Outcomes for Patients With Myeloid Disease Receiving Antithymocyte Globulin-Based Haploidentical Hematopoietic Stem Cell Transplantation

• Published in: Frontiers in immunology Vol. 11; p. 614488
• Main Authors: Zhao, Yanmin, Gao, Fei, Wu, Yibo, Shi, Jimin, Luo, Yi, Tan, Yamin, Yu, Jian, Lai, Xiaoyu, Zhang, Mingming, Zhang, Wei, Huang, He
• Format: Journal Article
• Language: English
• Published: Switzerland Frontiers Media S.A 04.02.2021
• Subjects: hematopoietic stem cell transplantation; iKIR-HLA model; Immunology; KIR; relapse; survival; hematopoietic stem cell transplantation; KIR; relapse; iKIR-HLA model; survival
• ISSN: 1664-3224; 1664-3224
• DOI: 10.3389/fimmu.2020.614488

Hematopoietic stem cell transplantation (HSCT) is a curative therapy for patients with malignant hematologic diseases. Killer immunoglobin-like receptor (KIR) expressed by NK cells is closely associated with the transplant outcomes, and it has been widely explored and debated for a few decades. Recently published studies have revealed that inhibitory KIRs (iKIRs) are educated by their cognate human lymphocyte antigen (HLA) ligands, and that decreased iKIR-HLA pairs post-transplantation may indicate a reduced NK cell function and impaired control of the primary disease. However, this theory still needs to be validated by additional clinical studies. Here we conducted a retrospective analysis of 246 patients who received haploidentical (haplo)-HSCT at our treatment center between January 2015 and June 2018. Our data suggests that decreased iKIR-HLA C pair post-HSCT correlated with a significantly higher risk of relapse [hazard risk (HR) = 2.95, p = 0.019] and reduced overall survival (OS) (HR = 3.74, p = 0.001) and disease-free survival (DFS) (HR = 4.05, p = 0.0004) in patients with myeloid disease. In conclusion, decreased iKIR-HLA C pair should be avoided during anti-thymocyte globulin (ATG)-based haplo-HSCT, especially for patients with myeloid disease.