The effect of killer cell Immunoglobulin - like receptor genotype on Outcome of hematopoietic stem cell transplantation from a matched donor / Sally Mahmoud Mohamed Elfishawi ; Supervised Azza Mahmoud Kamel , Alaa Elhaddad , Ghada Ibrahim Mossallam

Thesis (Ph.D.) - Cairo University - National Cancer Institute - Department of Clinical Pathology

Successful allogeneic HSCT depends also on T-cell mediated GVL effect, in which donor - derived T cells clear the remaining leukemic cells in patient. In addition to alloreactive T cells, donor - derived natural killer (NK) cells are able to kill malignant or virus-infected cells in the patient. NK cells have a crucial role in relapse prevention by destroying remaining acute myeloid leukemia cells. Natural killer cells are regulated by their surface receptors KIR, which have either activating or inhibitory function by interacting with HLA class I, HLA - C alleles and Bw4 alleles, present on normal cell surface. Fifteen KIR genes can be categorized into inhibitory (KIR A- haplotype) or activating haplotypes (KIR B haplotype) based on their gene content. These haplotypes can be further divided as telomeric and centromeric parts, which contain either A- or B- motifs according to the presence or absence of A- or B- haplotype defining KIR genes. Studies showed that acute myeloid leukemia (AML) patients benefit from the KIR-ligand mismatch due to the 2missing self3 phenomenon. In addition, there is evidence that the risk of relapse is reduced in those AML patients whose donors have several activating KIR genes or KIR - B gene- motifs in unrelated donor HSC

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