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Bakhtiari T, Ahmadvand M, Salmaninejad A, Ghaderi A, Yaghmaie M, Sadeghi A, Mousavi SA, Rostami T, Ganjalikhani-Hakemi M. The Influence of KIR Gene Polymorphisms and KIR-ligand Binding on Outcomes in Hematologic Malignancies following Haploidentical Stem Cell Transplantation: A Comprehensive Review. Curr Cancer Drug Targets 2023; 23:868-878. [PMID: 37226789 DOI: 10.2174/1568009623666230523155808] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2022] [Revised: 03/10/2023] [Accepted: 04/03/2023] [Indexed: 05/26/2023]
Abstract
Natural killer (NK) cell behavior and function are controlled by a balance between negative or positive signals generated by an extensive array of activating and inhibiting receptors, including killer cell immunoglobulin-like receptor (KIR) proteins, main components of the innate immune system that contribute to initial responses against viral infected-transformed cells through generation of the release of cytokines and cytotoxicity. What is certain is that KIRs are genetically polymorphic and the extent of KIRs diversity within the individuals may have the potential outcomes for hematopoietic stem cell transplantation (HSCT). In this regard, recent studies suggest that KIR is as imperative as its ligand (HLA) in stem cell transplantation for malignant diseases. However, unlike HLA epitope mismatches, which are well-known causes of NK alloreactivity, a complete understanding of KIR genes' role in HSCT remains unclear. Because of genetic variability in KIR gene content, allelic polymorphism, and cell-surface expression among individuals, an appropriate selection of donors based on HLA and KIR profiles is crucial to improve outcomes of stem cell transplantation. In addition, the impact of the KIR/HLA interaction on HSCT outcomes needs to be investigated more comprehensively. The present work aimed to review the NK cell regeneration, KIR gene polymorphisms, and KIRligand binding on outcomes in hematologic malignancies following haploidentical stem cell transplantation. Comprehensive data gathered from the literature can provide new insight into the significance of KIR matching status in transplantations.
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Affiliation(s)
- Tahereh Bakhtiari
- Department of Immunology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mohammad Ahmadvand
- Cell Therapy and Hematopoietic Stem Cell Transplantation Research Center, Research Institute for Oncology, Hematology, and Cell Therapy, Tehran University of Medical Sciences, Tehran, Iran
| | - Arash Salmaninejad
- Department of Medical Genetics, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
- Regenerative Medicine, Organ Procurement and Transplantation Multi-Disciplinary Center, Razi Hospital, School of Medicine, Guilan University Medical Sciences, Rasht, Iran
| | - Afshin Ghaderi
- Department of Internal Medicine, Hematology and Medical Oncology Ward, Yasuj University of Medical Sciences, Yasuj, Iran
| | - Marjan Yaghmaie
- Cell Therapy and Hematopoietic Stem Cell Transplantation Research Center, Research Institute for Oncology, Hematology, and Cell Therapy, Tehran University of Medical Sciences, Tehran, Iran
| | - Alireza Sadeghi
- Department of Internal Medicine, Faculty of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Seied Asadollah Mousavi
- Cell Therapy and Hematopoietic Stem Cell Transplantation Research Center, Research Institute for Oncology, Hematology, and Cell Therapy, Tehran University of Medical Sciences, Tehran, Iran
| | - Tahereh Rostami
- Cell Therapy and Hematopoietic Stem Cell Transplantation Research Center, Research Institute for Oncology, Hematology, and Cell Therapy, Tehran University of Medical Sciences, Tehran, Iran
| | - Mazdak Ganjalikhani-Hakemi
- Department of Immunology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
- Department of Immunology, Faculty of Medicine, Yeditepe University, Istanbul, Turkey
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Impact of CTLA4 genotype and other immune response gene polymorphisms on outcomes after single umbilical cord blood transplantation. Blood 2016; 129:525-532. [PMID: 27811020 DOI: 10.1182/blood-2016-06-722249] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2016] [Accepted: 10/17/2016] [Indexed: 12/25/2022] Open
Abstract
We evaluated the impact of recipient and cord blood unit (CBU) genetic polymorphisms related to immune response on outcomes after unrelated cord blood transplantations (CBTs). Pretransplant DNA samples from 696 CBUs with malignant diseases were genotyped for NLRP1, NLRP2, NLRP3, TIRAP/Mal, IL10, REL, TNFRSF1B, and CTLA4. HLA compatibility was 6 of 6 in 10%, 5 of 6 in 39%, and ≥4 of 6 in 51% of transplants. Myeloablative conditioning was used in 80%, and in vivo T-cell depletion in 81%, of cases. The median number of total nucleated cells infused was 3.4 × 107/kg. In multivariable analysis, patients receiving CBUs with GG-CTLA4 genotype had poorer neutrophil recovery (hazard ratio [HR], 1.33; P = .02), increased nonrelapse mortality (NRM) (HR, 1.50; P < .01), and inferior disease-free survival (HR, 1.41; P = .02). We performed the same analysis in a more homogeneous subset of cohort 1 (cohort 2, n = 305) of patients who received transplants for acute leukemia, all given a myeloablative conditioning regimen, and with available allele HLA typing (HLA-A, -B, -C, and -DRB1). In this more homogeneous but smaller cohort, we were able to demonstrate that GG-CTLA4-CBU was associated with increased NRM (HR, 1.85; P = .01). Use of GG-CTLA4-CBU was associated with higher mortality after CBT, which may be a useful criterion for CBU selection, when multiple CBUs are available.
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Goyal RK, Lee SJ, Wang T, Trucco M, Haagenson M, Spellman SR, Verneris M, Ferrell RE. Novel HLA-DP region susceptibility loci associated with severe acute GvHD. Bone Marrow Transplant 2016; 52:95-100. [PMID: 27595289 DOI: 10.1038/bmt.2016.210] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2016] [Revised: 06/02/2016] [Accepted: 06/17/2016] [Indexed: 12/17/2022]
Abstract
Despite HLA allele matching, significant acute GvHD remains a major barrier to successful unrelated donor BMT. We conducted a genome-wide association study (GWAS) to identify recipient and donor genes associated with the risk of acute GvHD. A case-control design (grade III-IV versus no acute GvHD) and pooled GWA approach was used to study European-American recipients with hematological malignancies who received myeloablative conditioning non-T-cell-depleted first transplantation from HLA-A, -B, -C, -DRB1, -DQB1 allele level (10/10) matched unrelated donors. DNA samples were divided into three pools and tested in triplicate using the Affymetrix Genome-wide SNP Array 6.0. We identified three novel susceptibility loci in the HLA-DP region of recipient genomes that were associated with III-IV acute GvHD (rs9277378, P=1.58E-09; rs9277542, P=1.548E-06 and rs9277341, P=7.718E-05). Of these three single nucleotide polymorphisms (SNPs), rs9277378 and rs9277542 are located in non-coding regions of the HLA-DPB1 gene and the two are in strong linkage disequilibrium with two other published SNPs associated with acute GvHD, rs2281389 and rs9277535. Eighteen other recipient SNPs and 3 donor SNPs with a high level of significance (8E-07 or lower) were found. Our report contributes to emerging data showing clinical significance of the HLA-DP region genetic markers beyond structural matching of DPB1 alleles.
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Affiliation(s)
- R K Goyal
- Department of Pediatric of Blood and Marrow Transplantation and Cellular Therapies, Children's Hospital of Pittsburgh of UPMC, Pittsburgh, PA, USA.,Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.,Division of Hematology, Oncology and Blood and Marrow Transplantation, Department of Pediatrics, Children's Mercy Hospital, Kansas City, MO, USA
| | - S J Lee
- Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA.,Department of Biostatistics, Center for International Blood and Marrow Transplant Research, Medical College of Wisconsin, Milwaukee, WI, USA
| | - T Wang
- Department of Biostatistics, Center for International Blood and Marrow Transplant Research, Medical College of Wisconsin, Milwaukee, WI, USA
| | - M Trucco
- Division of Immunogenetics, Children's Hospital of Pittsburgh of UPMC, University of Pittsburgh, Pittsburgh, PA, USA
| | - M Haagenson
- Department of Immunobiology and Observational Research, Center for International Blood and Marrow Transplant Research, Minneapolis, MN, USA
| | - S R Spellman
- Department of Immunobiology and Observational Research, Center for International Blood and Marrow Transplant Research, Minneapolis, MN, USA
| | - M Verneris
- Department of Pediatric BMT, University of Minnesota, Minneapolis, MN, USA
| | - R E Ferrell
- Department of Human Genetics, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA
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Zhang W, He Y, Wang W, Han Z, He J, Chen N, Dong L, Tao S, He J, Zhu F, Lv H. HLA-A locus allelic dropout in Sanger sequence-based typing due to the single nucleotide polymorphism of exon 1. Int J Immunogenet 2015; 42:457-60. [DOI: 10.1111/iji.12234] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2015] [Revised: 07/20/2015] [Accepted: 07/24/2015] [Indexed: 11/26/2022]
Affiliation(s)
- W. Zhang
- Blood Center of Zhejiang Province; Hangzhou Zhejiang China
- Key Laboratory of Blood Safety Research; Ministry of Health; Hangzhou Zhejiang China
| | - Y. He
- Blood Center of Zhejiang Province; Hangzhou Zhejiang China
- Key Laboratory of Blood Safety Research; Ministry of Health; Hangzhou Zhejiang China
| | - W. Wang
- Blood Center of Zhejiang Province; Hangzhou Zhejiang China
- Key Laboratory of Blood Safety Research; Ministry of Health; Hangzhou Zhejiang China
| | - Z. Han
- Blood Center of Zhejiang Province; Hangzhou Zhejiang China
- Key Laboratory of Blood Safety Research; Ministry of Health; Hangzhou Zhejiang China
| | - J. He
- Blood Center of Zhejiang Province; Hangzhou Zhejiang China
- Key Laboratory of Blood Safety Research; Ministry of Health; Hangzhou Zhejiang China
| | - N. Chen
- Blood Center of Zhejiang Province; Hangzhou Zhejiang China
- Key Laboratory of Blood Safety Research; Ministry of Health; Hangzhou Zhejiang China
| | - L. Dong
- Blood Center of Zhejiang Province; Hangzhou Zhejiang China
- Key Laboratory of Blood Safety Research; Ministry of Health; Hangzhou Zhejiang China
| | - S. Tao
- Blood Center of Zhejiang Province; Hangzhou Zhejiang China
- Key Laboratory of Blood Safety Research; Ministry of Health; Hangzhou Zhejiang China
| | - J. He
- Blood Center of Zhejiang Province; Hangzhou Zhejiang China
- Key Laboratory of Blood Safety Research; Ministry of Health; Hangzhou Zhejiang China
| | - F. Zhu
- Blood Center of Zhejiang Province; Hangzhou Zhejiang China
- Key Laboratory of Blood Safety Research; Ministry of Health; Hangzhou Zhejiang China
| | - H. Lv
- Blood Center of Zhejiang Province; Hangzhou Zhejiang China
- Key Laboratory of Blood Safety Research; Ministry of Health; Hangzhou Zhejiang China
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Cheng C, Kashi ZM, Martin R, Woodruff G, Dinauer D, Agostini T. HLA-C locus allelic dropout in Sanger sequence-based typing due to intronic single nucleotide polymorphism. Hum Immunol 2014; 75:1239-43. [DOI: 10.1016/j.humimm.2014.09.016] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2014] [Revised: 09/27/2014] [Accepted: 09/27/2014] [Indexed: 11/25/2022]
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6
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Wang D, Gao S, Xu Y, He L, Zhen J, Zou H. Identification of a novel HLA-C*04 allele, HLA-C*04:162. ACTA ACUST UNITED AC 2014; 83:200-1. [PMID: 24438379 DOI: 10.1111/tan.12285] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2013] [Accepted: 12/09/2013] [Indexed: 11/28/2022]
Abstract
HLA-C*04:162 differs from the closely matching allele C*04:01:01:01 by one nucleotide substitution in exon 4 at position 883 A/G.
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Affiliation(s)
- D Wang
- Immunogenetics Laboratory, Shenzhen Blood Center, Shenzhen, Guangdong, China
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7
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Schellekens J, Gagne K, Marsh SGE. Natural killer cells and killer-cell immunoglobulin-like receptor polymorphisms: their role in hematopoietic stem cell transplantation. Methods Mol Biol 2014; 1109:139-58. [PMID: 24473783 DOI: 10.1007/978-1-4614-9437-9_9] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Natural killer (NK) cells are important effector cells in the early control of infected, malignant, and "nonself" cells. Various receptor families are involved in enabling NK cells to detect and efficiently eliminate these target cells. The killer-cell immunoglobulin-like receptor (KIR) family is a set of receptors that are very polymorphic with regard to gene content, expression level, and expression pattern. KIRs are responsible for the induction of a NK cell alloreactive response through their interaction with HLA class I molecules. The role of NK cells in hematopoietic stem cell transplantation (HSCT) has been studied for many years, and induction of antileukemic responses by donor NK cells has been reported. Conflicting data still exist on the exact circumstances in which the KIR repertoire affects and influences clinical outcome after HSCT. More large-scale studies are needed on well-defined cohorts to unravel the mechanism of action of the NK cell-mediated alloresponse in an HSCT setting.
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8
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Liu N, Zhang Z, Shan X, Wang L, Cui S. A novel HLA-B allele, B*07:55, identified by sequence-based typing. TISSUE ANTIGENS 2013; 81:121-123. [PMID: 23278383 DOI: 10.1111/tan.12045] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/28/2012] [Revised: 10/22/2012] [Accepted: 11/19/2012] [Indexed: 06/01/2023]
Abstract
The novel allele differs from HLA-B*07:02:01 by a single nucleotide substitution at position 538 in exon 3.
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Affiliation(s)
- N Liu
- HLA Laboratory, Beijing Red Cross Blood Center, Beijing, China
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Conway SE, Abdi R. Immunoregulatory gene polymorphisms and graft-versus-host disease. Expert Rev Clin Immunol 2010; 5:523-34. [PMID: 20477640 DOI: 10.1586/eci.09.44] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Graft-versus-host disease (GVHD) remains a significant complication that greatly enhances morbidity and mortality associated with hematopoietic stem cell transplantation. Key immunoregulatory molecules have been implicated in the pathogenesis of GVHD, but the mechanisms by which these molecules affect the incidence and severity of GVHD have not been fully elucidated. The effects of genetic polymorphisms in immunoregulatory molecules, including cytokines, costimulatory and adhesion molecules, pharmacogenes and growth factors, have been shown to play a central role in GVHD. The results of these polymorphism studies contribute to the identification of predictive risk factors for GVHD based on individual polymorphism makeup. This review summarizes investigations of genetic polymorphisms in immunoregulatory molecules significantly associated with GVHD over the last 5 years.
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Affiliation(s)
- Susan E Conway
- Brigham and Women's Hospital, Harvard Medical School, Transplantation Research Center, 221 Longwood Avenue, EBRC 312, Boston, MA 02115, USA
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10
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Investigation of Functional IL-10 Gene Polymorphism and IL-10 Levels in Acute Graft-Versus-Host Disease. J Clin Immunol 2010; 30:465-73. [DOI: 10.1007/s10875-010-9377-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2009] [Accepted: 02/01/2010] [Indexed: 02/05/2023]
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11
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Brixner V, Martin H, Seidl C, Seifried E. A haplotype HLA-A*3201 - B*0702 - Cw*07 with a new HLA-C allelic variant closely related to HLA-Cw*0702 found in a Caucasian patient suffering from leukaemia. ACTA ACUST UNITED AC 2009; 74:169-70. [PMID: 19422666 DOI: 10.1111/j.1399-0039.2009.01266.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
The novel allele human leucocyte antigen (HLA)-Cw*0746 differs from HLA-Cw*070101 by three nucleotide exchanges at codons 45 and 66 in exon 2 and at codon 99 in exon 3.
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Affiliation(s)
- V Brixner
- Department of Transplantation Immunology, Institute of Transfusion Medicine and Immunohematology, Frankfurt am Main, Germany.
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12
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Shah R, Selby ST, Yokley B, Slack RS, Hurley CK, Posch PE. TNF, LTA and TGFB1 genotype distributions among acute graft-vs-host disease subsets after HLA-matched unrelated hematopoietic stem cell transplantation: a pilot study. ACTA ACUST UNITED AC 2009; 74:50-6. [PMID: 19392797 DOI: 10.1111/j.1399-0039.2009.01257.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Cytokine single nucleotide polymorphisms and consequent production levels have been associated with acute graft-vs-host disease (aGVHD) development. The aim of this pilot study was to determine whether polymorphisms in tumor necrosis factor (TNF), lymphotoxin alpha (LTA) and transforming growth factor beta 1 (TGFB1) showed any association with aGVHD severity. Novel alleles and polymorphisms were identified for each cytokine locus. Genotype distributions were examined in 38 recipient-donor pairs (all chronic myelogenous leukemia in the first chronic phase) with either low-grade (grades 0-I) or high-grade (grades III-IV) aGVHD. Although no significant differences were found, some trends were noted in genotype distributions among aGVHD-grade groups. Power calculations determined that substantially more pairs would be required to show significant associations in distributions among aGVHD-grade groups.
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Affiliation(s)
- R Shah
- Department of Oncology, Georgetown University Medical Center, Washington, DC 20057, USA
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The diversity of KIR gene in Chinese Northern Han population and the impact of donor KIR and patient HLA genotypes on outcome following HLA-identical sibling allogeneic hematopoietic stem cell transplantation for hematological malignancy in Chinese people. Int J Hematol 2008; 87:422-433. [DOI: 10.1007/s12185-008-0058-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2006] [Revised: 12/20/2007] [Accepted: 01/25/2008] [Indexed: 10/22/2022]
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Handgretinger R, Kurtzberg J, Egeler RM. Indications and donor selections for allogeneic stem cell transplantation in children with hematologic malignancies. Pediatr Clin North Am 2008; 55:71-96, x. [PMID: 18242316 DOI: 10.1016/j.pcl.2007.10.013] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Allogeneic stem cell transplantation (SCT) is the only curative approach for many patients with advanced or high-risk leukemia. Advances in supportive care and management of graft-versus-host disease have resulted in improvements in outcomes of related and unrelated donor SCT, creating controversies as to which strategy might be the optimal therapy for individual patients. This article discusses the indications and donor selection strategies for SCT in patients with malignant hematologic disease.
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Affiliation(s)
- Rupert Handgretinger
- Department of Hematology/Oncology and General Pediatrics, Children's University Hospital, Hoppe-Seyler-Strasse 1, Tuebingen, Germany.
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Thompson EM, Kashi ZM, Martin RK, Alcorn JL, Tidey L. Identification of the novel HLA-C allele Cw*0751. ACTA ACUST UNITED AC 2007; 71:178-9. [PMID: 18069932 DOI: 10.1111/j.1399-0039.2007.00981.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
We report the novel HLA-Cw allele HLA-Cw*0751. The allele was identified during routine sequence-based typing in our laboratory. The novel allele is identical to Cw*07020101 except for a single nucleotide change in codon 90.2 in position 268. HLA-Cw*0751 allele possesses an adenine at position 268 in exon 2, while HLA-Cw*07020101 has a cytosine at this position. Although this substitution does not change serologic reactivity of HLA-Cw7 molecule, it changes the amino acid at codon 90 from an aspartic acid to an alanine. Aspartic acid is polar and acidic, while alanine is non-polar and neutral.
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Affiliation(s)
- E M Thompson
- Kashi Clinical Laboratories, Beaverton, OR 97008, USA.
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Shimada M, Onizuka M, Machida S, Suzuki R, Kojima M, Miyamura K, Kodera Y, Inoko H, Ando K. Association of autoimmune disease-related gene polymorphisms with chronic graft-versus-host disease. Br J Haematol 2007; 139:458-63. [PMID: 17868046 DOI: 10.1111/j.1365-2141.2007.06797.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Chronic graft-versus-host disease (GVHD) is the most common cause of poor outcomes after haematopoietic stem cell transplantation (HSCT), while the pathophysiology of chronic GVHD remains poorly understood. As both chronic GVHD and autoimmune disease share clinical features, we speculated that autoimmune disease-related genes might be candidate chronic GVHD-related genes. Recent large-scale cohort studies showed that Fc receptor-like 3 gene (FCRL3) single nucleotide polymorphism (SNP) and peptidylarginine deiminases citrullinating enzymes 4 gene (PADI4) haplotype were associated with autoimmune disease. The present study investigated the association between polymorphisms of these two genes and the incidence of chronic GVHD. We analysed 123 cases of Japanese human leucocyte antigen-matched sibling recipients and their donors who underwent HSCT. Although PADI4, which is the rheumatoid arthritis-specific related gene, was not associated with the occurrence of chronic GVHD, the recipient FCRL3-169C/C genotype was significantly less frequent in chronic GVHD patients than in those without chronic GVHD (P = 0.0086). There was no relationship between FCRL3 polymorphism and acute GVHD. As FCRL3 is expressed by B cells and might have an important role in immunoregulation, this significant protective genetic effect raises the question of whether FCRL3 might also be involved in the pathogenesis of chronic GVHD.
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Affiliation(s)
- Masako Shimada
- Department of Haematology and Oncology, Tokai University School of Medicine, Isehara, Kanagawa, Japan
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Schmidt AH, Stahr A, Baier D, Schumacher S, Ehninger G, Rutt C. Selective recruitment of stem cell donors with rare human leukocyte antigen phenotypes. Bone Marrow Transplant 2007; 40:823-30. [PMID: 17724442 DOI: 10.1038/sj.bmt.1705832] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Many patients in need of a hematopoietic stem cell transplant do not find a fully matching donor although more than 11,000,000 potential donors are registered worldwide. Therefore, it is relevant to recruit donors who add diversity to the donor pool. We present the 'Roots' approach that includes the selection of already registered donors with rare HLA phenotypes and the recruitment of relatives of these donors. Two projects (Roots A and B) with different donor selection criteria were carried out. HLA phenotype frequency distributions of new donors differ significantly from the respective control groups: 2.7% of Roots A donors versus 1.1% of the control group have an HLA-AB phenotype that is unique in the DKMS file (P=0.001). Additionally, 39.5% of Roots B donors but only 18.3% of the control group have a unique HLA-ABDR phenotype (P<0.001). Similar results are found when phenotypes that are at most available 10 times in the DKMS donor file are analyzed. The results show that the Roots approach is generally suited to increasing the ratio of donors with rare HLA phenotypes in a donor file. Additional costs of Roots donor recruitment seem justified through the ratio of recruited donors with rare HLA phenotypes.
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Affiliation(s)
- A H Schmidt
- DKMS German Bone Marrow Donor Center, Tübingen, Germany.
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Cirocco RE, Mathew JM, Burke GW, Esquenazi V, Miller J. Killer cell immunoglobulin-like receptor polymorphisms in HLA-identical kidney transplant recipients: lack of 2DL2 and 2DS2 may be associated with poor graft function. ACTA ACUST UNITED AC 2007; 69 Suppl 1:123-4. [PMID: 17445184 DOI: 10.1111/j.1399-0039.2006.76211.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Killer cell immunoglobulin-like receptors (KIR) on natural killer cells mediate killing by recognizing class I presentation of peptides by infected or oncogenic cells. KIR differences in stem cell transplants have been implicated in increased graft vs host disease. Human leukocyte antigen (HLA)-matched-related kidney recipients have the best graft survival as compared to one haplotype-matched recipients. These HLA-identical transplant pairs may be ideal for studying minor HLA antigens and KIR polymorphic differences and their relation to graft function. We have studied KIR polymorphism in recipients and donor pairs of HLA-matched sibling kidney transplants to demonstrate differences in genotype as related to long-term graft function and/or chronic rejection. We employed a KIR genotyping kit (Dynal, Brown Deer, WI), that uses sequence-specific priming by PCR to identify 19 alleles for genotypes in 12 donor/recipient (D/R) pairs at least 1 year posttransplant. There were two pairs that had different alleles in the recipient that were not found in the donor. One pair had different alleles found in the donor that were not present in the recipient. Two pairs had difference in alleles in both the donor and recipient. Seven of the 12 pairs had the same KIR genotype. Eight of the 12 pairs (both donor and recipient) exhibited a haplotype with 2DL2+ and 2DS2+. Four of the 12 exhibited a haplotype 2DL2- and 2DS2-. Three out of four of these recipients had increased creatinine levels and at least one graded rejection episode. One of these three has lost their graft. In conclusion, the genotyping of HLA-matched sibling kidney transplant D/R pairs demonstrates that there may be an association of higher risk for poor graft function when both genotypes lack 2DL2 and 2DS2.
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Affiliation(s)
- R E Cirocco
- The Lillian Jean Kaplan Renal Transplant Center of the Division of Transplantation of the Department of Surgery at the University of Miami, Leonard M. Miller School of Medicine, Miami, FL 33136, USA.
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Mullighan CG, Bardy PG. New directions in the genomics of allogeneic hematopoietic stem cell transplantation. Biol Blood Marrow Transplant 2007; 13:127-44. [PMID: 17241919 DOI: 10.1016/j.bbmt.2006.10.018] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2006] [Accepted: 10/10/2006] [Indexed: 01/09/2023]
Abstract
Despite optimal supportive care and high-resolution HLA matching, complications such as GVHD and infection remain major barriers to the success of allogeneic HCT (allo-HCT). This has led to growing interest in the non-HLA genetic determinants of complications after allo-HCT. Most studies have examined genetic predictors of GVHD, relapse, and mortality and have focused on 3 main areas: minor histocompatibility antigen (miHAs), inflammatory mediators of GVHD, and more recently NK cell-mediated allorecognition. The genetic basis of other outcomes such as infection and drug toxicity are less well studied but are being actively investigated. High-throughput methodologies such as single nucleotide polymorphism arrays are enabling the study of hundreds of thousands of genetic markers throughout the genome and the interrogation of novel genetic variants such as copy number variations. These data offer the opportunity to better predict those at risk of complications and to identify novel targets for therapeutic intervention. This review examines the current data regarding the non-HLA genomics of allo-HCT and appraises the promises and pitfalls for integration of this new genetic information into clinical transplantation practice.
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Affiliation(s)
- Charles G Mullighan
- Pathology, St Jude Children's Research Hospital, Memphis, Tennessee 38105, USA.
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Takahashi S, Ooi J, Tomonari A, Konuma T, Tsukada N, Oiwa-Monna M, Fukuno K, Uchiyama M, Takasugi K, Iseki T, Tojo A, Yamaguchi T, Asano S. Comparative single-institute analysis of cord blood transplantation from unrelated donors with bone marrow or peripheral blood stem-cell transplants from related donors in adult patients with hematologic malignancies after myeloablative conditioning regimen. Blood 2007; 109:1322-30. [PMID: 17038536 DOI: 10.1182/blood-2006-04-020172] [Citation(s) in RCA: 212] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
We studied the clinical outcomes of 171 adults with hematologic malignancies who received unrelated cord blood transplantation (CBT) as a primary unrelated stem-cell source (n=100), or bone marrow transplant (BMT) or peripheral blood stem-cell transplant (PBSCT) from related donors (n=71, 55 BMT and 16 PBSCT). All patients received myeloablative regimens including 12 Gy total body irradiation. We analyzed the hematologic recovery, and risks of graft-versus-host disease (GVHD), transplantation-related mortality (TRM) and relapse, and disease-free survival (DFS) using Cox proportional hazards models. Significant delays in engraftment occurred after cord blood transplantation; however, overall engraftment rates were almost the same for both grafts. The cumulative incidences of grades III to IV acute and extensive-type chronic GVHDs among CBT recipients were significantly lower than those among BMT/PBSCT recipients. Multivariate analysis demonstrated no apparent differences in TRM (9% in CBT and 13% in BMT/PBSCT recipients), relapse (17% in CBT and 26% in BMT/PBSCT recipients), and DFS (70% in CBT and 60% in BMT/PBSCT recipients) between both groups. These data suggest that unrelated cord blood could be as safe and effective a stem-cell source as related bone marrow or mobilized peripheral blood for adult patients when it is used as a primary unrelated stem-cell source.
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Affiliation(s)
- Satoshi Takahashi
- Division of Molecular Therapy, Institute of Medical Science, Department of Biostatistics/Epidemiology and Preventive Health Sciences, School of Health Sciences and Nursing, University of Tokyo, Japan.
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Wiseman RW, O'Connor DH. Major histocompatibility complex-defined macaques in transplantation research. Transplant Rev (Orlando) 2007. [DOI: 10.1016/j.trre.2007.01.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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