The activating killer cell immunoglobulin-like receptors as important determinants of acute graft-versus host disease in hematopoietic stem cell transplantation for acute myelogenous leukemia

BACKGROUND. We investigated the influence of killer cell immunoglobulin-like receptor (KIR) genes, based on the genotypes of inhibitory or activating KIR, in stem cell recipients with acute myelogenous leukemia and their human leukocyte antigen-matched sibling donors on acute graft-versus host disease (GVHD) after hematopoietic stem cell transplantation. METHODS. We studied 53 consecutive donor-recipient pairs to determine the impact of KIR genotypes and their bidirectional KIR interactions. RESULTS. All activating KIR genes in donors were important factors for determining outcome in a manner distinctive for each gene studied. Specifically, the 2DS2 gene and the 2DS4*003 allele were closely correlated with acute GVHD. The 2DS1 gene was associated with a better long-term survival, even if present only in the donor and not the recipient. The 2DS3-2DS5 dual genes were more often involved in a variety of transplant-related complications. CONCLUSIONS. In conclusion, these factors may help predict transplant outcomes and aid in our understanding of immunogenetic specificity.