نقش ترکیب KIR-HLA در پیوند سلول‌های بنیادی خون‌ساز

Background : Allogeneic hematopoietic stem cells transplantation (HSCT) is a valuable therapy for refractory acute leukemias, leukemias with a high risk for relapse, myelodysplastic syndromes, and chronic myeloid leukemia. HSCT outcome is dependent on several factors, including the stage of disease, degree of human leukocyte antigen (HLA) identity between donor and recipient, conditioning regimen, and development of graft-versus-host disease (GVHD). Recent studies have indicated that another potential factor influencing transplantation outcome is the presence of donor-derived alloreactive natural killer (NK) cells. NK cell alloreactivity has been defined as a mismatch between the donor and recipient killer immunoglobulin-like receptor (KIR) ligands (ligand-ligand model), or as recipient lacking KIR ligands for donor inhibitory KIR (receptor-ligand model), or as a mismatch between the donor and recipient KIR genes (gene-gene model). The anti-leukemic effects of NK cell alloreactivity include lower rates of relapse, graft failure, and GVHD, ultimately translating into higher overall survival (OS). However, the effects of NK cell alloreactivity on the outcome of HSCT in malignant hematopoietic diseases is a topic of debatable.