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Blood, 15 January 2009, Vol. 113, No. 3, pp. 726-732. Prepublished online as a Blood First Edition Paper on October 22, 2008; DOI 10.1182/blood-2008-07-171926. This Article Full Text Full Text (PDF) Supplemental Table All Versions of this Article: blood-2008-07-171926v1 113/3/726    most recent Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Rights and Permissions Citing Articles Citing Articles via CrossRef Citing Articles via Google Scholar Google Scholar Articles by Cooley, S. Articles by Weisdorf, D. J. Search for Related Content PubMed PubMed Citation Articles by Cooley, S. Articles by Weisdorf, D. J. Related Collections Neoplasia Transplantation Free Research Articles Myeloid Neoplasia Clinical Trials and Observations Social Bookmarking                   What's this?  Previous Article  |  Table of Contents  |  Next Article  TRANSPLANTATION Donors with group B KIR haplotypes improve relapse-free survival after unrelated hematopoietic cell transplantation for acute myelogenous leukemia Sarah Cooley1, Elizabeth Trachtenberg2, Tracy L. Bergemann1, Koy Saeteurn2, John Klein3, Chap T. Le1, Steven G. E. Marsh4, Lisbeth A. Guethlein5, Peter Parham5, Jeffrey S. Miller1, and Daniel J. Weisdorf1 1 University of Minnesota, Minneapolis; 2 Childrens Hospital Oakland Research Institute, CA; 3 Medical College of Wisconsin, Milwaukee; 4 Anthony Nolan Research Institute, London, United Kingdom; and 5 Stanford University, CA Survival for patients with acute myeloid leukemia (AML) is limited by treatment-related mortality (TRM) and relapse after unrelated donor (URD) hematopoietic cell transplantation (HCT). Natural killer (NK)–cell alloreactivity, determined by donor killer-cell immunoglobulin-like receptors (KIRs) and recipient HLA, correlates with successful HCT for AML. Hypothesizing that donor KIR genotype (A/A: 2 A KIR haplotypes; B/x: at least 1 B haplotype) would affect outcomes, we genotyped donors and recipients from 209 HLA-matched and 239 mismatched T-replete URD transplantations for AML. Three-year overall survival was significantly higher after transplantation from a KIR B/x donor (31% [95% CI: 26-36] vs 20% [95% CI: 13-27]; P = .007). Multivariate analysis demonstrated a 30% improvement in the relative risk of relapse-free survival with B/x donors compared with A/A donors (RR: 0.70 [95% CI: 0.55-0.88]; P = .002). B/x donors were associated with a higher incidence of chronic graft-versus-host disease (GVHD; RR: 1.51 [95% CI: 1.01-2.18]; P = .03), but not of acute GVHD, relapse, or TRM. This analysis demonstrates that unrelated donors with KIR B haplotypes confer significant survival benefit to patients undergoing T-replete HCT for AML. KIR genotyping of prospective donors, in addition to HLA typing, should be performed to identify HLA-matched donors with B KIR haplotypes. CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?

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