HLA-C KIR-Ligands Determine the Impact of Anti-Thymocyte Globulin (ATG) on Graft versus Host and Graft versus Leukemia Effects Following Hematopoietic Stem Cell Transplantation.

As shown in Figure 1 A, in recipients of HLA-matched HSCT with at least one C1 group allele (i.e., C1/1 or C1/2; n = 634), ATG was associated with a non-significant survival advantage in the unadjusted univariate analysis, but with a highly significant advantage (RR, 0.52; p = 0.0003) in multivariate analysis, adjusting for the most relevant confounding factor, unrelated donor.

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In C1/2 recipients, reduction of NRM by ATG was less pronounced, yet marginally significant, if all ATG doses were included (RR, 0.61; p = 0.04; n = 363), and was slightly more pronounced if only the lower ATG dose levels were considered (RR, 0.56; p = 0.026; n = 320).

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Stratification by KIR-L status revealed that this effect was most prominent in the C1/1 KIR-L group (RR, 0.28; p = 0.0002; n = 291), while being of borderline significance in the C1/2 KIR-L group (RR, 0.55; p = 0.04; n = 363).

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