Characteristics of transplants with donor-vs-recipient NK-cell alloreactivity
| . | Donor KIR genotype* . | |||
|---|---|---|---|---|
| . | Cen-A/A, n = 28 . | Cen-B/x, n = 41 . | Tel-A/A, n = 43 . | Tel-B/x, n = 26 . |
| Patient sex, n (%) | ||||
| Male | 12 (43) | 20 (49) | 19 (44) | 13 (50) |
| Female | 16 (57) | 21 (51) | 24 (56) | 13 (50) |
| Median age (range), years | 42 (14-58) | 35 (14-62) | 39 (16-62) | 30.5 (14-59) |
| Disease, n (%) | ||||
| AML | 23 (82) | 37 (90) | 36 (84) | 24 (92) |
| ALL | 5 (18) | 4 (10) | 7 (16) | 2 (8) |
| Disease status at transplant, n (%) | ||||
| High-risk† complete remission | 21 (75) | 28 (68) | 28 (65) | 21 (81) |
| Chemoresistant relapse‡ | 7 (25) | 13 (32) | 15 (35) | 5 (19) |
| CMV serostatus (donor/recipient), n (%) | ||||
| Positive/positive | 26 (93) | 36 (88) | 39 (91) | 23 (88) |
| Positive/negative | 1 (3.5) | 2 (5) | 2 (5) | 1 (4) |
| Negative/positive | 0 (0) | 2 (5) | 1 (2) | 1 (4) |
| Negative/negative | 1 (3.5) | 1 (2) | 1 (2) | 1 (4) |
| Donor/recipient relationship, n (%) | ||||
| Maternal donor | 6 (21) | 7 (17) | 7 (16) | 6 (23) |
| Other donor | 22 (79) | 34 (83) | 36 (84) | 20 (77) |
| Transplant protocol, n (%) | ||||
| T cell–depleted§ | 20 (71) | 33 (80) | 33 (77) | 20 (77) |
| Treg/Tcon¶ | 8 (29) | 8 (20) | 10 (23) | 6 (23) |
| Conditioning regimen#, n (%) | ||||
| T cell–depleted protocol | ||||
| TBI, thiotepa, fludarabine, antithymocyte globulin** | 20 (71) | 33 (80.5) | 33 (77) | 20 (77) |
| Treg/Tcon protocol | ||||
| TBI, thiotepa, fludarabine, cyclophosphamide | 5 (18) | 7 (17) | 7 (16) | 5 (19) |
| TBI, thiotepa, fludarabine, alemtuzumab, or thymoglobulin | 3 (11) | 1 (2.5) | 3 (7) | 1 (4) |
| Graft composition (mean ± SD) | ||||
| CD34+ × 106/kg | 10.2 ± 3.3 | 11.9 ± 4.4 | 11.1 ± 4.0 | 11.4 ± 4.2 |
| CD3+ × 104/kg | 2.3 ± 2.2 | 3.2 ± 3.9 | 2.5 ± 2.8 | 3.3 ± 4.0 |
| . | Donor KIR genotype* . | |||
|---|---|---|---|---|
| . | Cen-A/A, n = 28 . | Cen-B/x, n = 41 . | Tel-A/A, n = 43 . | Tel-B/x, n = 26 . |
| Patient sex, n (%) | ||||
| Male | 12 (43) | 20 (49) | 19 (44) | 13 (50) |
| Female | 16 (57) | 21 (51) | 24 (56) | 13 (50) |
| Median age (range), years | 42 (14-58) | 35 (14-62) | 39 (16-62) | 30.5 (14-59) |
| Disease, n (%) | ||||
| AML | 23 (82) | 37 (90) | 36 (84) | 24 (92) |
| ALL | 5 (18) | 4 (10) | 7 (16) | 2 (8) |
| Disease status at transplant, n (%) | ||||
| High-risk† complete remission | 21 (75) | 28 (68) | 28 (65) | 21 (81) |
| Chemoresistant relapse‡ | 7 (25) | 13 (32) | 15 (35) | 5 (19) |
| CMV serostatus (donor/recipient), n (%) | ||||
| Positive/positive | 26 (93) | 36 (88) | 39 (91) | 23 (88) |
| Positive/negative | 1 (3.5) | 2 (5) | 2 (5) | 1 (4) |
| Negative/positive | 0 (0) | 2 (5) | 1 (2) | 1 (4) |
| Negative/negative | 1 (3.5) | 1 (2) | 1 (2) | 1 (4) |
| Donor/recipient relationship, n (%) | ||||
| Maternal donor | 6 (21) | 7 (17) | 7 (16) | 6 (23) |
| Other donor | 22 (79) | 34 (83) | 36 (84) | 20 (77) |
| Transplant protocol, n (%) | ||||
| T cell–depleted§ | 20 (71) | 33 (80) | 33 (77) | 20 (77) |
| Treg/Tcon¶ | 8 (29) | 8 (20) | 10 (23) | 6 (23) |
| Conditioning regimen#, n (%) | ||||
| T cell–depleted protocol | ||||
| TBI, thiotepa, fludarabine, antithymocyte globulin** | 20 (71) | 33 (80.5) | 33 (77) | 20 (77) |
| Treg/Tcon protocol | ||||
| TBI, thiotepa, fludarabine, cyclophosphamide | 5 (18) | 7 (17) | 7 (16) | 5 (19) |
| TBI, thiotepa, fludarabine, alemtuzumab, or thymoglobulin | 3 (11) | 1 (2.5) | 3 (7) | 1 (4) |
| Graft composition (mean ± SD) | ||||
| CD34+ × 106/kg | 10.2 ± 3.3 | 11.9 ± 4.4 | 11.1 ± 4.0 | 11.4 ± 4.2 |
| CD3+ × 104/kg | 2.3 ± 2.2 | 3.2 ± 3.9 | 2.5 ± 2.8 | 3.3 ± 4.0 |
TBI, total body irradiation.
Donor KIR genotypes are indicated as A/A when they did not contain B haplotypes; the centromeric segment is termed “Cen-A/A” and the telomeric “Tel-A/A.” Donor KIR genotypes are indicated as B/x when they contained at least 1 B haplotype; the centromeric segments are termed “Cen-B/x” and the telomeric “Tel-B/x.” Distribution of variables did not differ significantly in transplants from Cen-A/A vs Cen-B/x donors and Tel-A/A vs Tel-B/x donors (P > .05).
Myelodysplasia or unfavorable cytogenetics or first-line induction therapy failure in first to third complete remission.
Morphologic evidence of leukemic cells in the bone marrow and/or blood after treatment.
T cell–depleted granulocyte colony-stimulating factor (G-CSF)–mobilized peripheral blood CD34+ hematopoietic progenitor cell graft.3-5
T cell–depleted G-CSF–mobilized peripheral blood CD34+ hematopoietic progenitor cell graft and Treg/Tcon infusion.6,7
See supplemental Table 1 for details on conditioning regimens.
Four patients received cyclophosphamide instead of fludarabine.3