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Blood, 1 July 2007, Vol. 110, No. 1, pp. 433-440. Prepublished online as a Blood First Edition Paper on March 19, 2007; DOI 10.1182/blood-2006-07-038687. This Article Full Text (PDF) All Versions of this Article: blood-2006-07-038687v1 110/1/433    most recent Alert me when this article is cited Alert me if a correction is posted 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 HighWire Citing Articles via CrossRef Citing Articles via Google Scholar Google Scholar Articles by Ruggeri, L. Articles by Velardi, A. Search for Related Content PubMed PubMed Citation Articles by Ruggeri, L. Articles by Velardi, A. Social Bookmarking                   What's this?  Previous Article  |  Next Article  Submitted July 31, 2006 Accepted March 12, 2007 Donor natural killer cell allorecognition of missing self in haploidentical hematopoietic transplantation for acute myeloid leukemia: challenging its predictive value Loredana Ruggeri, Antonella Mancusi, Marusca Capanni, Elena Urbani, Alessandra Carotti, Teresa Aloisi, Martin Stern, Daniela Pende, Katia Perruccio, Emanuela Burchielli, Fabiana Topini, Erika Bianchi, Franco Aversa, Massimo Fabrizio Martelli, and Andrea Velardi* Division of Hematology & Clinical Immunology, Dept of Clinical Medicine, Univ of Perugia, IRCCS Foundation on Transplantation Biotechnologies, Perugia, Italy Istituto Nazionale per la Ricerca sul Cancro, Genova, Italy * Corresponding author; email: velardi{at}unipg.it. We analyzed 112 patients with high-risk acute myeloid leukemia (61 in complete remission (CR); 51 in relapse), who received human leukocyte-antigen (HLA)-haploidentical transplants from natural killer (NK) alloreactive (n=51) or non-NK alloreactive donors (n=61). NK alloreactive donors possessed: HLA-class I, Killer-cell Immunoglobulin-like Receptor (KIR) ligand(s) which were missing in the recipients, KIR gene(s) for missing self recognition on recipient targets, and alloreactive NK clones against recipient targets. Transplantation from NK-alloreactive donors was associated with: a significantly lower relapse rate in patients transplanted in CR (3% vs 47%) (P<0.003); better event-free survival in patients transplanted in relapse (34% vs 6%, P=0.04) and in remission (67% vs 18%, P=0.02); reduced risk of relapse or death (relative risk vs non-NK-alloreactive donor: 0.48 [95% CI 0.29-0.78], P<0.001). In all patients we tested the "missing ligand" model which pools KIR ligand mismatched transplants and KIR ligand-matched transplants from donors possessing KIR(s) for which neither donor nor recipient have HLA ligand(s). Only transplantation from NK-alloreactive donors is associated with a survival advantage. CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this? This article has been cited by other articles: U. Langenkamp, U. Siegler, S. Jorger, S. Diermayr, A. Gratwohl, C. P. Kalberer, and A. Wodnar-Filipowicz Human acute myeloid leukemia CD34+CD38- stem cells are susceptible to allorecognition and lysis by single KIR-expressing natural killer cells Haematologica, November 1, 2009; 94(11): 1590 - 1594. [Abstract] [Full Text] [PDF] C. Sola, P. Andre, C. Lemmers, N. Fuseri, C. Bonnafous, M. Blery, N. R. Wagtmann, F. Romagne, E. Vivier, and S. 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