PMID- 17673900
OWN - NLM
STAT- MEDLINE
DCOM- 20071025
LR  - 20221109
IS  - 0887-6924 (Print)
IS  - 0887-6924 (Linking)
VI  - 21
IP  - 10
DP  - 2007 Oct
TI  - Rapid natural killer cell recovery determines outcome after T-cell-depleted 
      HLA-identical stem cell transplantation in patients with myeloid leukemias but 
      not with acute lymphoblastic leukemia.
PG  - 2145-52
AB  - Natural killer (NK) cells are the first lymphocytes to recover after allogeneic 
      stem cell transplantation (SCT) and can exert powerful graft-versus-leukemia 
      (GVL) effects determining transplant outcome. Conditions governing NK cell 
      alloreactivity and the role of NK recovery in sibling SCT are not well defined. 
      NK cells on day 30 post-transplant (NK30) were measured in 54 SCT recipients with 
      leukemia and donor and recipient killer immunoglobulin-like receptor (KIR) 
      genotype determined. In univariate analysis, donor KIR genes 2DL5A, 2DS1, 3DS1 
      (positive in 46%) and higher numbers of inhibitory donor KIR correlated with 
      higher NK30 counts and were associated with improved transplant outcome. NK30 
      counts also correlated directly with the transplant CD34 cell dose and inversely 
      with the CD3+ cell dose. In multivariate analysis, the NK30 emerged as the single 
      independent determinant of transplant outcome. Patients with NK30 >150/microl had 
      less relapse (HR 18.3, P=0.039), acute graft-versus-host disease (HR 3.2, 
      P=0.03), non-relapse mortality (HR 10.7, P=0.028) and improved survival (HR 11.4, 
      P=0.03). Results suggest that T cell-depleted SCT might be improved and the GVL 
      effect enhanced by selecting donors with favorable KIR genotype, and by 
      optimizing CD34 and CD3 doses.
FAU - Savani, B N
AU  - Savani BN
AD  - Stem Cell Transplantation Section, Hematology Branch, National Institutes of 
      Health, Bethesda, MD 20892-1202, USA.
FAU - Mielke, S
AU  - Mielke S
FAU - Adams, S
AU  - Adams S
FAU - Uribe, M
AU  - Uribe M
FAU - Rezvani, K
AU  - Rezvani K
FAU - Yong, A S M
AU  - Yong AS
FAU - Zeilah, J
AU  - Zeilah J
FAU - Kurlander, R
AU  - Kurlander R
FAU - Srinivasan, R
AU  - Srinivasan R
FAU - Childs, R
AU  - Childs R
FAU - Hensel, N
AU  - Hensel N
FAU - Barrett, A J
AU  - Barrett AJ
LA  - eng
PT  - Journal Article
DEP - 20070802
PL  - England
TA  - Leukemia
JT  - Leukemia
JID - 8704895
RN  - 0 (Antigens, CD34)
RN  - 0 (CD3 Complex)
RN  - 0 (HLA Antigens)
RN  - EC 3.6.5.2 (GEM protein, human)
RN  - EC 3.6.5.2 (Monomeric GTP-Binding Proteins)
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Antigens, CD34/biosynthesis
MH  - CD3 Complex/biosynthesis
MH  - Child
MH  - Cohort Studies
MH  - Female
MH  - Genotype
MH  - Graft vs Leukemia Effect
MH  - HLA Antigens/*metabolism
MH  - Humans
MH  - Killer Cells, Natural/*cytology/metabolism
MH  - Leukemia, Myeloid/*metabolism
MH  - Male
MH  - Middle Aged
MH  - Monomeric GTP-Binding Proteins/metabolism
MH  - Precursor Cell Lymphoblastic Leukemia-Lymphoma/*metabolism
MH  - Stem Cell Transplantation/*methods
MH  - T-Lymphocytes/*metabolism
MH  - Transplantation Conditioning
MH  - Transplantation, Homologous
EDAT- 2007/08/04 09:00
MHDA- 2007/10/27 09:00
CRDT- 2007/08/04 09:00
PHST- 2007/08/04 09:00 [pubmed]
PHST- 2007/10/27 09:00 [medline]
PHST- 2007/08/04 09:00 [entrez]
AID - 2404892 [pii]
AID - 10.1038/sj.leu.2404892 [doi]
PST - ppublish
SO  - Leukemia. 2007 Oct;21(10):2145-52. doi: 10.1038/sj.leu.2404892. Epub 2007 Aug 2.