Table 1.
Impact of NK cells reconstitution on outcomes after allogeneic HSCT.
| Study | Pts, n | Male, n (%) | Age (yrs), Median (range) | Donor Type, n (%) | Graft source, n (%) | Diagnosis, n (%) | Conditioning, n (%) | GVHD Prophylaxis, n (%); T- cell Depletion | Follow up, median (range) months | Acute GVHD, n (%), Grade | Relapse, n (%) | CMV reactivation, n (%) | OS, (%) years (Y) |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Lang et al.
a
(2011) (18) |
47 | NA | 8.6 | MUD 18 (38) Haplo 29 (61) |
BM 47 (100) | ALL 27 (57), AML 10 (21), MDS 2 (4.2), CML 4 (8.5), JMML 1 (2), Lymphoma 3 (6) | MAC 47 (100) | NR; yes | NA | NA | G1:11 (10), G2: 5.5 (25), G3: 4.5 (50), G4: 0 (0) | NR | NA |
| Ando et al. b (2020) (19) | 246 | 152 (61.8) | 51 (18-69) | NA | BM 98 (39.8) PB 36 (14.6) UCB 112 (45.5) |
AML 131 (53.4), ALL 61 (24.8), MDS 32(13), CML 7 (2.8), MPN 7 (2.8), other 8(3.2) | MAC 99 (40.2), RIC 147(59.8) | Tac, CSA; no | 38.4 (9.6-115) |
98 (40), >II | NA | 141 (57) | High: 75 Low: 35.7 at 5Y |
| Chang et al. c (2008) (20) | 43 | 29 (67) | 27 (13-40) | Haplo 43 (100) | PB 43 (100) | AML 14 (33), ALL 12 (28), CML 16 (37), MDS 1 (2) | MAC 43 (100) | CSA, MTX, MMF; yes | 12 (1.4 –23) | 25 (58), >II | High:0 (0) Low: 3 (21) |
NR | High: 92.9, Middle: 66.7 Low: 42.9 at 2Y |
| Kheav et al. (2014) (21) | 439 | NA | 44 (15-68) | MSD 237 (54) MUD 151 (33.9) MMUD 51(12) |
PB 336 (76.5) BM103 (23.5) |
AML 104 (23.7) ALL 57 (13) NHL 49 (11.2), HL 19 (4.3), MM 42 (9.6), MPN 40 (9.1), MDS 52 (11.8), other 76 (17) |
RIC 266 (60.6) MAC 173 (39.4) | NR; no | NA | 205 (48), >II | 89 (22) | 269 (61.5) | NA |
| Dunbar et al.
d
(2008) (22) |
167 | Low: 39 (47) High:16 (56) | Low: 44 High: 48 | MSD/MUD 149 (89) UCB 10 (5.9) single HLA-MM 8 (4.7) |
PB 157(94) UCB 10(5.9) |
NA | MAC 79 (47) RIC 43(25) |
Tac; MMF; no | 12.3 (2.2-58) | High: 13 (34) Low: 40 (34), I |
HR: 20.2 (Low vs high) |
NR | High: 72 Low: 83 at 1 Y |
| Kim et al. e (2016) (23) | 70 | 34 (49) | 42 (20-64) | MSD 34 (48.5) Haplo 6 (8.5) MUD 19 (2.7) MMUD 11 (15.7) |
PB 59 (84) BM 11 (16) |
ALL 14 (20), AML 33 (47), CML 3 (4.3) MDS 8 (11) MM 3 (4.3), lymphoma 3 (4.3) other 6 (8.6) |
MAC 41 (59) RIC 29 (41) |
NA; yes | 32.8 | 35 (50), >I | 21 (30) | NR | High: HR 1, Low: HR 2.24 1.04-4.83) at 1 Y |
| Minculescu et al. f (2016) (17) | 298 NK<150: 102 NK>150: 196 |
173 (58) NK <150: 37 (36) NK >150: 88 (44.8) |
55 (16-74) NK <150 53 (16-74) NK >150 55 (18-73) |
MSD 100 (33.5) MUD 198 (66) |
PB 60 (20) BM 238 (79.8) |
ALL 42 (14), AML 165 (55), MDS 91 (30.5) | MAC 107 (35.9) RIC 191 (64) |
MAC: CSA, MTX and RIC: Tac, MMF; no Non-MAC: Tacrolimus +MMF; no |
47.9 (15.6-122) |
127 (43), > I | 64 (21) | High: 37 (19) Low: 35 (34) |
High: 76 Low: 61.8 at 1 Y |
| McCurdy et al g (2022) (16) | 145 | MSD/MUD 55 (73) Haplo 46 (65) |
MSD/MUD 49 (22-64) Haplo 41 (2-64) |
MSD 35 (24) MUD 40 (28) Haplo 70 (48) |
BM 145 (100) | NA | MAC 145 (100) | PTCy, Tac, MMF; no | NR | II-IV 55 (38) III-IV 16 (11) |
High: 21 Low: 35 at 2 Y |
MSD/MUD 39 (53) Haplo 28 (40) |
High: 81 Low: 50 at 2 Y |
Groups were divided based on the patterns of NK activity. Group 1 (consistently low activity <10% specific lysis), group 2 (consistently high activity >30% specific lysis), group 3 (initially high activity then decreasing), group 4 (initially low activity, then increasing to normal levels).
Not mentioned.
High (>9.27 cells/μL, n=14), Middle (3.59 to 9.27 cells/μL, n=51), Low (<3.59 cells/μL, n=14).
ANK levels were designated from the cluster analysis and counts greater than 18.2 cells/mm3 at 60 days were considered in the high level (n=84) and counts less than this value was considered in the low level (n=38).
Cut-off values were different for 30 days vs 90 days post-transplant. For 30 days post-transplant the cut-off was <177.5/μL. For 90 days post-transplant cut-off was <181.9 cells/μL. OS was HR=1 at High NK and HR=2.64(0.76-9.21) at Low NK.
High: NK30>150, Low: NK30<150.
High NK cell count: >50.5 cells/mL and Low NK cell count: £50.5 cells/mL
OS, overall survival; NA, not available; ALL, acute lymphoid leukemia; AML, acute myeloid leukemia; BM, bone marrow; UCB, umbilical cord blood; CLL, chronic lymphoid leukemia; HL, Hodgkin lymphoma; JMML, juvenile myelomonocytic leukemia; MAC, myeloablative conditioning; MDS, myelodysplastic syndrome; MUD, matched unrelated donor; MSD, matched sibling donor; Haplo-haploidentical donor; MMUD, mismatched unrelated donor; MM, multiple myeloma; NHL, non-Hodgkin lymphoma; NR, nonreported; PB, peripheral blood; RIC, reduced intensity conditioning; SAA, severe aplastic anemia; MPN, myeloproliferative neoplasm; TBI, total body irradiation; TCD, T-cell depleted; HR, hazard ratio; NMA, nonmyeloablative; AA, aplastic anemia; CSA, cyclosporin; Tac, tacrolimus; MMF, mycophenolate; MTX, methotrexate; PTCy, post-transplant cyclophosphamide.