Effect of missing KIR ligands on transplantation outcome
| Group . | Cohort size . | Relapse* . | aGVHD (grades II-IV)* . | TRM* . | DFS† . | ||||
|---|---|---|---|---|---|---|---|---|---|
| Hazard ratio (95% CI) . | P . | Hazard ratio (95% CI) . | P . | Hazard ratio (95% CI) . | P . | Hazard ratio (95% CI) . | P . | ||
| AML and MDS | 105 | ||||||||
| All KIR-L present | 38 | 1.00 (reference) | — | 1.00 (reference) | — | 1.00 (reference) | — | 1.00 (reference) | — |
| Missing 1 or more KIR-L | 67 | 0.79 (0.40-1.59) | .52 | 1.56 (0.79-3.08) | .20 | 2.19 (0.61-7.80) | .23 | 0.91 (0.50-1.65) | .74 |
| Missing HLA-C1 | 14 | 0.66 (0.20-2.16) | .49 | 1.68 (0.57-4.91) | .34 | 0.26 (0.03-2.43)‡ | .24‡ | 1.81 (0.66-4.95) | .25 |
| Missing HLA-C2 | 17 | 0.73 (0.27-1.96) | .53 | 2.87 (1.29-6.37) | .01 | 4.01 (0.98-16.40) | .05 | 0.68 (0.29-1.57) | .36 |
| Missing HLA-Bw4 | 9 | 0.68 (0.14-3.32) | .63 | 0.61 (0.12-3.05) | .55 | 0.29 (0.02-3.74)‡ | .36‡ | 1.71 (0.53-5.49) | .37 |
| Missing HLA-Bw4 and HLA-C1 or HLA-C2 | 27 | 0.90 (0.41-1.95) | .78 | 1.26 (0.51-3.12) | .62 | 0.43 (0.15-1.24) | .12 | 0.66 (0.32-1.36) | .25 |
| AML | 81 | ||||||||
| All KIR-L present | 28 | 1.00 | 1.00 | 1.00 | 1.00 | ||||
| Missing 1 or more KIR-L | 53 | 0.91 (0.40-2.08) | .84 | 1.52 (0.65-3.57) | .33 | 1.05 (0.26-4.17) | .94 | 0.91 (0.45-1.86) | .80 |
| MDS | 24 | ||||||||
| All KIR-L present | 10 | 1.00 | 1.00 | 1.00 | 1.00 | ||||
| Missing 1 or more KIR-L | 14 | 0.38 (0.10-1.45) | .15 | 1.80 (0.59-5.51) | .30 | 3.57 (0.71-17.9)‡ | .08‡ | 0.80 (0.27-2.40) | .69 |
| Subgroups of AML and MDS | |||||||||
| Patient with ATG treatment | 23 | ||||||||
| All KIR-L present | 12 | 1.00 | 1.00 | 1.00 | 1.00 | ||||
| Missing 1 or more KIR-L | 11 | 1.11 (0.34-3.58) | .86 | 0.36 (0.04-3.35) | .37 | 1.14 (0.08-16.05) | .92 | 1.00 (0.25-4.03) | 1.00 |
| Patient without ATG treatment | 82 | ||||||||
| All KIR-L present | 26 | 1.00 | 1.00 | 1.00 | 1.00 | ||||
| Missing 1 or more KIR-L | 56 | 0.78 (0.33-1.84) | .57 | 1.63 (0.76-3.51) | .22 | 2.41 (0.52-11.12) | .26 | 0.86 (0.42-1.77) | .69 |
| Patient receiving BM grafts | 35 | ||||||||
| All KIR-L present | 10 | 1.00 | 1.00 | 1.00 | 1.00 | ||||
| Missing 1 or more KIR-L | 25 | 0.51 (0.21-1.25) | .14 | 1.15 (0.32-4.11) | .83 | 2.01 (0.23-17.39) | .52 | 1.45 (0.57-3.68) | .43 |
| Patient receiving PBSC grafts | 70 | ||||||||
| All KIR-L present | 28 | 1.00 | 1.00 | 1.00 | 1.00 | ||||
| Missing 1 or more KIR-L | 42 | 1.17 (0.43-3.19) | .76 | 1.67 (0.75-3.72) | .21 | 2.23 (0.46-10.68) | .32 | 0.71 (0.31-1.59) | .40 |
| Patient with MAC | 76 | ||||||||
| All KIR-L present | 22 | 1.00 | 1.00 | 1.00 | 1.00 | ||||
| Missing 1 or more KIR-L | 54 | 0.68 (0.29-1.59) | .38 | 1.32 (0.62-2.84) | .48 | 2.14 (0.46-9.86) | .33 | 0.98 (0.47-2.06) | .97 |
| Patient with RIC | 29 | ||||||||
| All KIR-L present | 16 | 1.00 | 1.00 | 1.00 | 1.00 | ||||
| Missing 1 or more KIR-L | 13 | 1.31 (0.40-4.25) | .66 | 0.81 (0.15-4.46) | .81 | 1.31 (0.09-18.83) | .84 | 0.74 (0.23-2.34) | .61 |
| Group . | Cohort size . | Relapse* . | aGVHD (grades II-IV)* . | TRM* . | DFS† . | ||||
|---|---|---|---|---|---|---|---|---|---|
| Hazard ratio (95% CI) . | P . | Hazard ratio (95% CI) . | P . | Hazard ratio (95% CI) . | P . | Hazard ratio (95% CI) . | P . | ||
| AML and MDS | 105 | ||||||||
| All KIR-L present | 38 | 1.00 (reference) | — | 1.00 (reference) | — | 1.00 (reference) | — | 1.00 (reference) | — |
| Missing 1 or more KIR-L | 67 | 0.79 (0.40-1.59) | .52 | 1.56 (0.79-3.08) | .20 | 2.19 (0.61-7.80) | .23 | 0.91 (0.50-1.65) | .74 |
| Missing HLA-C1 | 14 | 0.66 (0.20-2.16) | .49 | 1.68 (0.57-4.91) | .34 | 0.26 (0.03-2.43)‡ | .24‡ | 1.81 (0.66-4.95) | .25 |
| Missing HLA-C2 | 17 | 0.73 (0.27-1.96) | .53 | 2.87 (1.29-6.37) | .01 | 4.01 (0.98-16.40) | .05 | 0.68 (0.29-1.57) | .36 |
| Missing HLA-Bw4 | 9 | 0.68 (0.14-3.32) | .63 | 0.61 (0.12-3.05) | .55 | 0.29 (0.02-3.74)‡ | .36‡ | 1.71 (0.53-5.49) | .37 |
| Missing HLA-Bw4 and HLA-C1 or HLA-C2 | 27 | 0.90 (0.41-1.95) | .78 | 1.26 (0.51-3.12) | .62 | 0.43 (0.15-1.24) | .12 | 0.66 (0.32-1.36) | .25 |
| AML | 81 | ||||||||
| All KIR-L present | 28 | 1.00 | 1.00 | 1.00 | 1.00 | ||||
| Missing 1 or more KIR-L | 53 | 0.91 (0.40-2.08) | .84 | 1.52 (0.65-3.57) | .33 | 1.05 (0.26-4.17) | .94 | 0.91 (0.45-1.86) | .80 |
| MDS | 24 | ||||||||
| All KIR-L present | 10 | 1.00 | 1.00 | 1.00 | 1.00 | ||||
| Missing 1 or more KIR-L | 14 | 0.38 (0.10-1.45) | .15 | 1.80 (0.59-5.51) | .30 | 3.57 (0.71-17.9)‡ | .08‡ | 0.80 (0.27-2.40) | .69 |
| Subgroups of AML and MDS | |||||||||
| Patient with ATG treatment | 23 | ||||||||
| All KIR-L present | 12 | 1.00 | 1.00 | 1.00 | 1.00 | ||||
| Missing 1 or more KIR-L | 11 | 1.11 (0.34-3.58) | .86 | 0.36 (0.04-3.35) | .37 | 1.14 (0.08-16.05) | .92 | 1.00 (0.25-4.03) | 1.00 |
| Patient without ATG treatment | 82 | ||||||||
| All KIR-L present | 26 | 1.00 | 1.00 | 1.00 | 1.00 | ||||
| Missing 1 or more KIR-L | 56 | 0.78 (0.33-1.84) | .57 | 1.63 (0.76-3.51) | .22 | 2.41 (0.52-11.12) | .26 | 0.86 (0.42-1.77) | .69 |
| Patient receiving BM grafts | 35 | ||||||||
| All KIR-L present | 10 | 1.00 | 1.00 | 1.00 | 1.00 | ||||
| Missing 1 or more KIR-L | 25 | 0.51 (0.21-1.25) | .14 | 1.15 (0.32-4.11) | .83 | 2.01 (0.23-17.39) | .52 | 1.45 (0.57-3.68) | .43 |
| Patient receiving PBSC grafts | 70 | ||||||||
| All KIR-L present | 28 | 1.00 | 1.00 | 1.00 | 1.00 | ||||
| Missing 1 or more KIR-L | 42 | 1.17 (0.43-3.19) | .76 | 1.67 (0.75-3.72) | .21 | 2.23 (0.46-10.68) | .32 | 0.71 (0.31-1.59) | .40 |
| Patient with MAC | 76 | ||||||||
| All KIR-L present | 22 | 1.00 | 1.00 | 1.00 | 1.00 | ||||
| Missing 1 or more KIR-L | 54 | 0.68 (0.29-1.59) | .38 | 1.32 (0.62-2.84) | .48 | 2.14 (0.46-9.86) | .33 | 0.98 (0.47-2.06) | .97 |
| Patient with RIC | 29 | ||||||||
| All KIR-L present | 16 | 1.00 | 1.00 | 1.00 | 1.00 | ||||
| Missing 1 or more KIR-L | 13 | 1.31 (0.40-4.25) | .66 | 0.81 (0.15-4.46) | .81 | 1.31 (0.09-18.83) | .84 | 0.74 (0.23-2.34) | .61 |
KIR-L indicates KIR ligand; PBSC, peripheral blood stem cell; and MAC, myeloablative conditioning.
Values obtained by proportional subdistribution hazard regression model of Fine and Gray in a competing risks setting. Competing events were relapse (for TRM), death without aGVHD within 100 days after the transplantation (for aGVHD), and death without relapse (for relapse).
Hazard ratio and confidence interval (CI) obtained by the Mantel-Haenszel method, P values by log-rank test.
Values obtained by the Mantel-Haenszel method, P values by log-rank test via GraphPad Prism software. (Fine and Gray analysis could not be used due to zero events in one of the groups.)