Multivariate analysis of relapse following unrelated donor HCT
| Variable . | Cohort size, no. . | Relative risk (95% CI) . | P . |
|---|---|---|---|
| Early: AML CR1, CML with CP1 less than 1 y from diagnosis, and MDS (RA) | 536 | ||
| Recipient ligand status | |||
| All KIR-L present | 182 | 1.00 (reference) | — |
| Missing 1 or more KIR-L | 354 | 0.54 (0.30-0.95) | .03 |
| Disease | |||
| AML | 95 | 1.00 (reference) | — |
| CML | 372 | 0.23 (0.12-0.42) | < .001 |
| MDS | 69 | 0.49 (0.21-1.17) | .11 |
| Early CML chronic phase more than 1 y from diagnosis | 481 | ||
| Recipient ligand status | |||
| All KIR-L present | 171 | 1.00 (reference) | — |
| Missing 1 or more KIR-L | 310 | 1.06 (0.51-2.21) | .88 |
| Intermediate: AML more than CR1 or first relapse, CML more than CP1 or AP, MDS no excess blasts | 706 | ||
| Recipient ligand status | |||
| All KIR-L present | 248 | 1.00 (reference) | — |
| Missing 1 or more KIR-L | 458 | 0.80 (0.57-1.13) | .21 |
| Disease | |||
| AML | 307 | 1.00 (reference) | — |
| CML | 303 | 0.76 (0.53-1.08) | .13 |
| MDS | 96 | 0.37 (0.19-0.71) | .003 |
| Advanced: AML in relapse, CML BC, MDS (RAEB/RAEBT) | 339 | ||
| Recipient ligand status | |||
| All KIR-L present | 118 | 1.00 (reference) | — |
| Missing 1 or more 1 KIR-L | 221 | 1.30 (0.83-2.04) | .26 |
| Disease | |||
| AML | 154 | 1.00 (reference) | — |
| CML | 68 | 0.77 (0.46-1.27) | .31 |
| MDS | 117 | 0.28 (0.16-0.49) | < .001 |
| Variable . | Cohort size, no. . | Relative risk (95% CI) . | P . |
|---|---|---|---|
| Early: AML CR1, CML with CP1 less than 1 y from diagnosis, and MDS (RA) | 536 | ||
| Recipient ligand status | |||
| All KIR-L present | 182 | 1.00 (reference) | — |
| Missing 1 or more KIR-L | 354 | 0.54 (0.30-0.95) | .03 |
| Disease | |||
| AML | 95 | 1.00 (reference) | — |
| CML | 372 | 0.23 (0.12-0.42) | < .001 |
| MDS | 69 | 0.49 (0.21-1.17) | .11 |
| Early CML chronic phase more than 1 y from diagnosis | 481 | ||
| Recipient ligand status | |||
| All KIR-L present | 171 | 1.00 (reference) | — |
| Missing 1 or more KIR-L | 310 | 1.06 (0.51-2.21) | .88 |
| Intermediate: AML more than CR1 or first relapse, CML more than CP1 or AP, MDS no excess blasts | 706 | ||
| Recipient ligand status | |||
| All KIR-L present | 248 | 1.00 (reference) | — |
| Missing 1 or more KIR-L | 458 | 0.80 (0.57-1.13) | .21 |
| Disease | |||
| AML | 307 | 1.00 (reference) | — |
| CML | 303 | 0.76 (0.53-1.08) | .13 |
| MDS | 96 | 0.37 (0.19-0.71) | .003 |
| Advanced: AML in relapse, CML BC, MDS (RAEB/RAEBT) | 339 | ||
| Recipient ligand status | |||
| All KIR-L present | 118 | 1.00 (reference) | — |
| Missing 1 or more 1 KIR-L | 221 | 1.30 (0.83-2.04) | .26 |
| Disease | |||
| AML | 154 | 1.00 (reference) | — |
| CML | 68 | 0.77 (0.46-1.27) | .31 |
| MDS | 117 | 0.28 (0.16-0.49) | < .001 |
Regression models were adjusted for recipient and donor age, sex, year of transplantation, cytomegalovirus status, HLA matching, GVHD prophylaxis, and pretransplantation performance status. Ninety-eight percent of patients received traditional fully ablative preparative regimens; 79% received cyclophosphamide and total body irradiation; and 19% received busulfan and cyclophosphamide. There were no differences in the use of preparative regimens by disease stage.
CP indicates chronic phase; RA, refractory anemia; KIR-L, killer immunoglobulin receptor ligand (Bw4, C1 or C2 group); AP, accelerated phase; BC, blast crisis; and —, reference value.