Donor KIR3DL1/3DS1 Gene and Recipient Bw4 KIR Ligand as Prognostic Markers for Outcome in Unrelated Hematopoietic Stem Cell Transplantation

Impact of KIR3DL1/3DS1 gene disparities on patient survival in unrelated HSCT. (A) Cumulative survival of patients who received transplants matched for KIR3DL1 (n=143, R⁺D⁺ and R⁻D⁻) was compared with that of patients who received KIR3DL1 mismatched transplants in both directions (n=21, R⁺D⁻ and R⁻D⁺). Unrelated D/R pairs were identical at the allelic level for HLA-A, -B, -Cw, -DRB1, and -DQB1 (n=164). (B) Cumulative survival of patients who received transplants matched for KIR3DS1 (R⁺D⁺, R⁻D⁻) or mismatched in the HVG direction (R⁺D⁻) (n=126) was compared with that of patients who received KIR3DS1 mismatched transplants in the GVH direction (n=37, R⁻D⁺). Unrelated D/R pairs were identical at the allelic level for HLA-A, -B, -Cw, -DRB1, and -DQB1 (n=164). A value of P ≤ .05 was considered as statistically significant.

Impact of donor KIR3DL1/3DS1 and recipient Bw4 ligand disparities on relapse incidence in unrelated HSCT. (A) Cumulative incidence of relapse in HLA-Bw4⁺ patients with malignant diseases grafted with a KIR3DS1⁺ donor (n=41) was compared to that in HLA-Bw4⁻ patients receiving a graft from a KIR3DS1⁺ donor (n=14). Unrelated D/R pairs were HLA identical at the allelic level for HLA-A, -B, -Cw, -DRB1, and -DQB1. (B) Cumulative incidence of relapse in HLA-Bw4⁺ patients with malignant diseases receiving a graft from a KIR3DL1⁺/3DS1⁺ donor (n=33) was compared to that in HLA-Bw4⁻ patients receiving a graft from a KIR3DL1⁺/3DS1⁺ donor (n=11). Unrelated D/R pairs were HLA identical at allelic level for HLA-A, -B, -Cw, -DRB1, and -DQB1. (C) Cumulative incidence of relapse in HLA-Bw4⁺ patients with malignant diseases receiving a graft from a KIR3DL1⁺/3DS1⁺ donor (n=27) was compared to that in HLA-Bw4⁻ patients receiving a graft from a KIR3DL1⁺/3DS1⁺ donor (n=11). Unrelated D/R pairs were HLA mismatched with at least 1 allele mismatch for HLA-A, -B, -Cw, -DRB1, or -DQB1 loci. A value of p ≤ .05 was considered as statistically significant. The Bw4 status was evaluated depending on HLA-A (A23, A24, A32) and -B allelic typing of the recipient.