PMID- 35236933 OWN - NLM STAT- MEDLINE DCOM- 20220512 LR - 20220530 IS - 1476-5365 (Electronic) IS - 0268-3369 (Linking) VI - 57 IP - 5 DP - 2022 May TI - Coexistence of HLA and KIR ligand mismatches as a risk factor for viral infection early after cord blood transplantation. PG - 781-789 LID - 10.1038/s41409-022-01621-w [doi] AB - Viral infection is one of the lethal adverse events after cord blood transplantation (CBT). Human leukocyte antigen (HLA) and killer immunoglobulin-like receptor (KIR) ligand divergences can increase the risk of viral infection due to conflicting interactions between virus-infected cells and immune cells. However, the relationship between these disparities and the frequency of viral infection after CBT remains to be evaluated. Herein, we have conducted a retrospective multicenter study to assess the effect of HLA and KIR ligand mismatches on viral infections after CBT. The study included 429 patients, among which 126 viral infections occurred before day 100. Viral infection was significantly associated with poorer overall survival (OS; hazard ratio [HR] 1.74, p < 0.01). Patients harboring >/=3 mismatches in the HLA allele and inhibitory KIR ligand mismatches (HLA & KIR mismatches) had a significantly greater prevalence of viral infection (HR 1.66, p = 0.04). Thus, patients with HLA & KIR mismatches had poorer outcomes in terms of non-relapse mortality (HR 1.61, p = 0.05). Our study demonstrates the unfavorable impacts of HLA & KIR mismatches on viral infections and non-relapse mortality after CBT. Evaluating the viral infection risk and performance of an appropriate and early intervention in high-risk patients and optimizing the graft selection algorithm could improve the outcome of CBTs. CI - (c) 2022. The Author(s), under exclusive licence to Springer Nature Limited. FAU - Iemura, Tomoki AU - Iemura T AD - Department of Hematology and Oncology, Graduate School of Medicine, Kyoto University, Kyoto, Japan. FAU - Arai, Yasuyuki AU - Arai Y AUID- ORCID: 0000-0002-9662-5093 AD - Department of Hematology and Oncology, Graduate School of Medicine, Kyoto University, Kyoto, Japan. ysykrai@kuhp.kyoto-u.ac.jp. AD - Department of Clinical Laboratory Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan. ysykrai@kuhp.kyoto-u.ac.jp. FAU - Kitawaki, Toshio AU - Kitawaki T AUID- ORCID: 0000-0002-6373-3442 AD - Department of Hematology and Oncology, Graduate School of Medicine, Kyoto University, Kyoto, Japan. FAU - Kanda, Junya AU - Kanda J AUID- ORCID: 0000-0002-6704-3633 AD - Department of Hematology and Oncology, Graduate School of Medicine, Kyoto University, Kyoto, Japan. FAU - Kondo, Tadakazu AU - Kondo T AUID- ORCID: 0000-0002-8959-6271 AD - Department of Hematology and Oncology, Graduate School of Medicine, Kyoto University, Kyoto, Japan. FAU - Ueda, Yasunori AU - Ueda Y AD - Department of Hematology/Oncology, Kurashiki Central Hospital, Okayama, Japan. FAU - Mori, Takuto AU - Mori T AD - Department of Hematology and Oncology, Graduate School of Medicine, Kyoto University, Kyoto, Japan. AD - Department of Hematology, Kobe City Medical Center General Hospital, Hyogo, Japan. FAU - Imada, Kazunori AU - Imada K AUID- ORCID: 0000-0002-0945-0513 AD - Department of Hematology, Japanese Red Cross Osaka Hospital, Osaka, Japan. FAU - Yonezawa, Akihito AU - Yonezawa A AD - Department of Hematology, Kokura Memorial Hospital, Fukuoka, Japan. FAU - Yago, Kazuhiro AU - Yago K AD - Department of Hematology, Shizuoka General Hospital, Shizuoka, Japan. FAU - Anzai, Naoyuki AU - Anzai N AD - Department of Hematology, Takatsuki Red Cross Hospital, Osaka, Japan. FAU - Kotani, Shinichi AU - Kotani S AD - Department of Hematology, Tenri Hospital, Nara, Japan. FAU - Nohgawa, Masaharu AU - Nohgawa M AD - Deparment of Hematology, Japanese Red Cross Wakayama Medical Center, Wakayama, Japan. FAU - Kitano, Toshiyuki AU - Kitano T AD - Department of Hematology, Kitano Hospital, Osaka, Japan. FAU - Itoh, Mitsuru AU - Itoh M AD - Department of Hematology, Kyoto City Hospital, Kyoto, Japan. FAU - Arima, Nobuyoshi AU - Arima N AD - Deparment of Hematology, Shinko Hospital, Hyogo, Japan. FAU - Moriguchi, Toshinori AU - Moriguchi T AD - Department of Hematology, Kyoto-Katsura Hospital, Kyoto, Japan. FAU - Watanabe, Mitsumasa AU - Watanabe M AD - Department of Hematology, Hyogo Prefectural Amagasaki General Medical Center, Hyogo, Japan. FAU - Tsuji, Masaaki AU - Tsuji M AD - Department of Hematology, Japan Red Cross Otsu Hospital, Shiga, Japan. FAU - Yamashita, Kouhei AU - Yamashita K AD - Department of Hematology and Oncology, Graduate School of Medicine, Kyoto University, Kyoto, Japan. FAU - Takaori-Kondo, Akifumi AU - Takaori-Kondo A AUID- ORCID: 0000-0001-7678-4284 AD - Department of Hematology and Oncology, Graduate School of Medicine, Kyoto University, Kyoto, Japan. CN - Kyoto Stem Cell Transplantation Group (KSCTG) LA - eng PT - Journal Article PT - Multicenter Study PT - Research Support, Non-U.S. Gov't DEP - 20220302 PL - England TA - Bone Marrow Transplant JT - Bone marrow transplantation JID - 8702459 RN - 0 (HLA Antigens) RN - 0 (Histocompatibility Antigens Class I) RN - 0 (Ligands) RN - 0 (Receptors, KIR) SB - IM MH - *Cord Blood Stem Cell Transplantation/adverse effects MH - HLA Antigens MH - *Hematopoietic Stem Cell Transplantation MH - Histocompatibility Antigens Class I MH - Humans MH - Ligands MH - Receptors, KIR/genetics MH - Risk Factors MH - *Virus Diseases/etiology EDAT- 2022/03/04 06:00 MHDA- 2022/05/14 06:00 CRDT- 2022/03/03 05:33 PHST- 2021/11/16 00:00 [received] PHST- 2022/02/14 00:00 [accepted] PHST- 2022/02/11 00:00 [revised] PHST- 2022/03/04 06:00 [pubmed] PHST- 2022/05/14 06:00 [medline] PHST- 2022/03/03 05:33 [entrez] AID - 10.1038/s41409-022-01621-w [pii] AID - 10.1038/s41409-022-01621-w [doi] PST - ppublish SO - Bone Marrow Transplant. 2022 May;57(5):781-789. doi: 10.1038/s41409-022-01621-w. Epub 2022 Mar 2.