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Blood, 15 May 2005, Vol. 105, No. 10, pp. 4135-4142.
Prepublished online as a Blood First Edition Paper on February 1, 2005; DOI 10.1182/blood-2004-10-4113.
Previous Article | Next Article 
Submitted October 27, 2004
Accepted January 25, 2005
NK cell reconstitution after haploidentical hematopoietic stem cell transplants: immaturity of NK cells and inhibitory effect of NKG2A override GvL effect
Stephanie Nguyen*, Nathalie Dhedin, Jean-Paul Vernant, Mathieu Kuentz, Ahmad Al Jijakli, Nathalie Rouas-Freiss, Edgardo D Carosella, Ali Boudifa, Patrice Debre, and Vincent Vieillard
Laboratoire d'Immunologie Cellulaire et Tissulaire INSERM U543, Hopital Pitie-Salpetriere, Paris, France; Service d'Hematologie Clinique, Hopital Pitie-Salpetriere, Paris, France
Service d'Hematologie Clinique, Hopital Pitie-Salpetriere, Paris, France
Service d'Hematologie Clinique, Hopital Henri Mondor, Creteil, France
CEA, Hopital Saint-Louis, Paris, France
Laboratoire d'Immunologie Cellulaire et Tissulaire INSERM U543, Hopital Pitie-Salpetriere, Paris, France
* Corresponding author; email: stephanienguyenquoc{at}hotmail.com.
Natural killer (NK) cell alloreactivity is reported to mediate strong GvL (graft versus leukemia) effect in patients after haploidentical stem cell transplantation (SCT) for acute myeloid leukemia (AML). Because subsequent immune reconstitution remains a major concern, we studied NK cell recovery in 10 AML patients who received haplomismatched SCT, among whom no GvL effect was observed, despite the mismatched KIR ligand in the GvH direction for 8 of 10 patients. NK cells generated after SCT exhibited an immature phenotype: the cytotoxic CD3- CD56dim subset was small, expression of immunoglobulin-like receptors (KIRs) and NKp30 was reduced, while CD94/NKG2A expression was increased. This phenotype was associated to in vitro lower levels of cytotoxicity against a K562 cell line and against primary mismatched AML blasts than donor samples. This impaired lysis was correlated with CD94/NKG2A expression in NK cell. Blockading CD94/NKG2A restored lysis against the AML blasts, which all expressed HLA-E, the ligand for CD94/NKG2A. Our present study allows a better understanding of the NK cell differentiation after SCT. These results revealed that the NK cells generated after haplo-mismatched SCT are blocked at an immature state characterized by specific phenotypic features and impaired functioning, having potential impact for immune responsiveness and transplantation outcome.

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