A higher CD34 + cell dose correlates with better event-free survival after KIR-ligand mismatched cord blood transplantation for childhood acute myeloid leukemia.

Autor: Ishida, Hisashi, Kawahara, Yuta, Tomizawa, Daisuke, Okamoto, Yasuhiro, Hama, Asahito, Cho, Yuko, Koh, Katsuyoshi, Koga, Yuhki, Yoshida, Nao, Sato, Maho, Terui, Kiminori, Miyagawa, Naoyuki, Watanabe, Akihiro, Takita, Junko, Kobayashi, Ryoji, Yamamoto, Masaki, Watanabe, Kenichiro, Okada, Keiko, Kato, Koji, Matsumoto, Kimikazu
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Zdroj: Journal of Hematology & Oncology; 4/29/2024, Vol. 17 Issue 1, p1-5, 5p
Abstrakt: Although killer Ig-like receptor ligands (KIR-L) mismatch has been associated with alloreactive natural killer cell activity and potent graft-versus-leukemia (GVL) effect among adults with acute myeloid leukemia (AML), its role among children with AML receiving cord blood transplantation (CBT) has not been determined. We conducted a retrospective study using a nationwide registry of the Japanese Society for Transplantation and Cellular Therapy. Patients who were diagnosed with de novo non-M3 AML and who underwent their first CBT in remission between 2000 and 2021 at under 16 years old were included. A total of 299 patients were included; 238 patients were in the KIR-L match group, and 61 patients were in the KIR-L mismatch group. The cumulative incidence rates of neutrophil recovery, platelet engraftment, and acute/chronic graft-versus-host disease did not differ significantly between the groups. The 5-year event-free survival (EFS) rate was 69.8% in the KIR-L match group and 74.0% in the KIR-L mismatch group (p = 0.490). Stratification by CD34 + cell dose into four groups revealed a significant correlation between CD34 + cell dose and EFS in the KIR-L mismatch group (p = 0.006) but not in the KIR-L match group (p = 0.325). According to our multivariate analysis, KIR-L mismatch with a high CD34 + cell dose (≥ median dose) was identified as an independent favorable prognostic factor for EFS (hazard ratio = 0.19, p = 0.029) and for the cumulative incidence of relapse (hazard ratio = 0.09, p = 0.021). Our results suggested that higher CD34 + cell doses are crucial for achieving a potent GVL effect in the context of KIR-L-mismatched CBT. [ABSTRACT FROM AUTHOR]
Databáze: Complementary Index
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