Alloreactive killer cells: hindrance and help for haematopoietic transplants

• Published in: Nature reviews. Immunology Vol. 3; no. 2; pp. 108 - 122
• Main Authors: Parham, Peter, McQueen, Karina L
• Format: Journal Article
• Language: English
• Published: England Nature Publishing Group 01.02.2003
• Subjects: Animals; Blood; Bone marrow; Cell division; Chemotherapy; Cytokines; Cytotoxicity; Dendritic Cells - immunology; Graft versus host disease; Graft vs Host Disease - etiology; Graft vs Host Disease - immunology; Graft vs Leukemia Effect - genetics; Graft vs Leukemia Effect - immunology; Hematopoietic Stem Cell Transplantation - adverse effects; Histocompatibility Testing; HLA Antigens; Humans; Immune system; Immunology; Isoantigens; Killer Cells, Natural - immunology; Leukemia; Lymphocyte Depletion; Lymphocytes; Lymphoma; Mice; Models, Immunological; Patients; Peptides; Receptors, Immunologic - genetics; Receptors, KIR; Skin; Stem cells; T-Lymphocytes - immunology; Transplantation; Transplants & implants
• ISSN: 1474-1733; 1474-1741
• DOI: 10.1038/nri999

Haematopoietic-cell transplantation is a treatment for leukaemia and lymphoma. To reduce the incidence of graft-versus-host disease (GVHD) caused by transplanted T cells, donors and recipients are HLA matched. For patients for whom a matched donor is not available, one option is transplantation from an HLA-mismatched relative who shares one HLA haplotype. This procedure is distinguished by the use of a stronger conditioning regimen for the patient and of a T-cell-depleted graft containing numerous stem cells. After transplantation, natural killer cells are prevalent, and they can include alloreactive cells that kill tumour cells and prevent GVHD. The alloreactions seem to be determined by the mismatched HLA class I ligands and their killer-cell immunoglobulin-like receptors.