Affiliation:
1. Bone Marrow Transplantation Center The First Affiliated Hospital, School of Medicine, Zhejiang University Hangzhou China
2. Liangzhu Laboratory Zhejiang University Medical Center Hangzhou China
3. Institute of Hematology Zhejiang University Hangzhou China
4. Zhejiang Province Engineering Laboratory for Stem Cell and Immunity Therapy Hangzhou China
5. Shanghai Tissuebank Biotechnology Co., Ltd Shanghai China
Abstract
Hematopoietic stem cell transplantation (HSCT) offers the highest curative potential for patients with hematological malignancies. Complications including infection, graft‐versus‐host disease (GVHD), and relapse reflect delayed or dysregulated immune reconstitution. After transplantation, NK cells rapidly reconstitute and are crucial for immune surveillance and immune tolerance. NK cell function is tightly regulated by killer immunoglobin‐like receptors (KIRs). Previous studies have revealed that donor KIRs, especially some activated KIRs (aKIRs) are closely related to transplant outcomes. Here, we performed a retrospective study, including 323 patients who received haploidentical (haplo) HSCT in our center. In univariate analysis, donor KIR2DS1, KIR2DS3 and KIR3DS1 gene protected patients with lymphoid disease from Epstein–Barr virus (EBV) and cytomegalovirus (CMV) reactivation, while donor KIR2DS1, KIR2DS5 and KIR3DS1 gene conferred a higher risk of CMV reactivation for patients with myeloid disease. Multivariate analysis confirmed that donor telomeric (Tel) B/x and KIR2DS3 gene best protected patients with lymphoid disease from EBV (p = 0.017) and CMV reactivation (p = 0.004). In myeloid disease, grafts lacking Tel B/x and KIR2DS5 gene correlated with the lowest risk of CMV reactivation (p = 0.018). Besides, donor aKIR genes did not influence the rates of GVHD, relapse, non‐relapse mortality (NRM) and overall survival (OS) in this study. The reactivation of EBV and CMV was associated with poor prognosis of haplo‐HSCT. In conclusion, we found that donor aKIR genes might have a synergistic effect on CMV and EBV reactivation after haplo‐HSCT. Whether the influence of donor aKIR genes varies with disease types remained to be studied.
Funder
National Key Research and Development Program of China
National Natural Science Foundation of China
Subject
Genetics,Immunology,Immunology and Allergy