KIR in Allogeneic Hematopoietic Stem Cell Transplantation: Need for a Unified Paradigm for Donor Selection
Authors
Dhuyser, Adèle
Aarnink, Alice
Pérès, Michaël
Jayaraman, Jyothi
Nemat-Gorgani, Neda
Rubio, Marie Thérèse
Traherne, James
Publication Date
2022-02-15Journal Title
Frontiers in Immunology
Publisher
Frontiers Media S.A.
Volume
13
Language
en
Type
Article
This Version
VoR
Metadata
Show full item recordCitation
Dhuyser, A., Aarnink, A., Pérès, M., Jayaraman, J., Nemat-Gorgani, N., Rubio, M. T., Trowsdale, J., & et al. (2022). KIR in Allogeneic Hematopoietic Stem Cell Transplantation: Need for a Unified Paradigm for Donor Selection. Frontiers in Immunology, 13 https://doi.org/10.3389/fimmu.2022.821533
Abstract
Allogeneic hematopoietic stem cell transplantation (aHSCT) is a lifesaving therapy for hematological malignancies. For years, a fully matched HLA donor was a requisite for the procedure. However, new immunosuppressive strategies have enabled the recruitment of viable alternative donors, particularly haploidentical donors. Over 95% of patients have at least two potential haploidentical donors available to them. To identify the best haploidentical donor, the assessment of new immunogenetic criteria could help. To this end, the clinical benefit of KIR genotyping in aHSCT has been widely studied but remains contentious. This review aims to evaluate the importance of KIR-driven NK cell alloreactivity in the context of aHSCT and explain potential reasons for the discrepancies in the literature. Here, through a non-systematic review, we highlight how the studies in this field and their respective predictive models or scoring strategies could be conceptually opposed, explaining why the role of NK cells remains unclear in aHCST outcomes. We evaluate the limitations of each published prediction model and describe how every scoring strategy to date only partly delivers the requirements for optimally effective NK cells in aHSCT. Finally, we propose approaches toward finding the optimal use of KIR genotyping in aHSCT for a unified criterion for donor selection.
Keywords
Immunology, killer immunoglobulin-like receptors (KIR), allogeneic hematopoietic stem cell transplantation (aHSCT), Donor selection, alloreactivity potential, predictive model
Identifiers
External DOI: https://doi.org/10.3389/fimmu.2022.821533
This record's URL: https://www.repository.cam.ac.uk/handle/1810/334535
Rights
Licence:
http://creativecommons.org/licenses/by/4.0/
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