What is the role for donor natural killer cells after nonmyeloablative conditioning?

Publication Type:

Journal Article

Source:

Biology of blood and marrow transplantation : journal of the American Society for Blood and Marrow Transplantation, Volume 15, Issue 5, p.580-8 (2009)

Keywords:

2009, Adolescent, Adult, Aged, Center-Authored Paper, Child, Child, Preschool, Clinical Research Division, Data Interpretation, Statistical, Female, Flow Cytometry Core Facility, Graft Survival, Graft vs Host Disease, Hematologic Neoplasms, Hematopoiesis, hematopoietic stem cell transplantation, Humans, Killer Cells, Natural, Male, Middle Aged, Public Health Sciences Division, Receptors, KIR, RECURRENCE, Regeneration, Research Trials Office Core Facility - Biostatistics Service, Retrospective Studies, Shared Resources, T-Lymphocytes, Time Factors, Tissue Donors, Transplantation Chimera, Transplantation Conditioning, Treatment Outcome, Young Adult

Abstract:

We investigated the impacts of the tempo of early (days 14, 28, and 42) donor T cell and natural killer (NK) cell engraftment, missing recipient killer cell immunoglobulin-like receptor (KIR) ligands, and numbers of donor inhibitory and activating KIR genes on hematopoietic cell transplantation (HCT) outcomes in 282 patients with hematologic malignancies given nonmyeloablative conditioning. Modeling chimerism levels as a continuous linear variable, we found that high early donor T cell chimerism was significantly associated with acute graft-versus-host disease (aGVHD) (P = .01), whereas high donor NK cell chimerism levels had no such association (P = .38). Conversely, high donor NK cell chimerism levels were significantly associated with low relapse risk (P = .0009), whereas no significant association was seen with high donor T cell chimerism (P = .10). The qualitative associations between donor T cell and NK cell chimerism levels and GVHD and relapse did not change after adjustment for the presence of recipient KIR ligands or numbers of donor inhibitory or activating KIR genes. Our data indicate that prompt engraftment of donor NK cells correlated with lessened risks of relapse, but not with GVHD, whereas the converse was true for T cells.