Impact of HLA mismatching at specific loci on transplant-related outcomes: associations between high- versus low-resolution HLA mismatch at specific loci and outcome after unrelated donor BMT
. | . | Engraftment . | . | . | Grade III-IV acute GVHD . | . | . | Chronic GVHD . | . | . | Mortality . | . | . | ||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Locus . | No. . | OR . | 95% CI . | P . | RR . | 95% CI . | P . | RR . | 95% CI . | P . | RR . | 95% CI . | P . | ||||||||
| HLA-A match | 1500 | 1.00 | — | — | 1.00 | — | — | 1.00 | — | — | 1.00 | — | — | ||||||||
| Hi-res mismatch | 157 | 0.95 | (0.40, 2.26) | .91 | 1.31 | (1.00, 1.70) | .05 | 1.25 | (0.91, 1.70) | .17 | 1.26 | (1.02, 1.55) | .03 | ||||||||
| Low-res mismatch | 217 | 0.51 | (0.24, 1.08) | .08 | 1.51 | (1.18, 1.95) | .001 | 1.42 | (1.09, 1.85) | .01 | 1.44 | (1.20, 1.74) | < .0001 | ||||||||
| HLA-B match | 1397 | 1.00 | — | — | 1.00 | — | — | 1.00 | — | — | 1.00 | — | — | ||||||||
| Hi-res mismatch | 270 | 1.66 | (0.75, 3.69) | .22 | 1.13 | (0.91, 1.42) | .27 | 1.07 | (0.83, 1.38) | .58 | 1.08 | (0.90, 1.28) | .41 | ||||||||
| Low-res mismatch | 207 | 0.72 | (0.34, 1.49) | .37 | 1.35 | (1.03, 1.76) | .03 | 0.95 | (0.68, 1.32) | .74 | 1.46 | (1.19, 1.80) | .0003 | ||||||||
| HLA-C match | 1125 | 1.00 | — | — | 1.00 | — | — | 1.00 | — | — | 1.00 | — | — | ||||||||
| Hi-res mismatch | 83 | 0.80 | (0.29, 2.24) | .68 | 0.83 | (0.58, 1.20) | .32 | 0.93 | (0.65, 1.32) | .66 | 0.96 | (0.72, 1.29) | .78 | ||||||||
| Low-res mismatch | 666 | 0.54 | (0.31, 0.93) | .03 | 1.24 | (1.03, 1.50) | .02 | 1.05 | (0.86, 1.28) | .61 | 1.21 | (1.06, 1.40) | .007 | ||||||||
| HLA-DRB1 match | 1563 | 1.00 | — | — | 1.00 | — | — | 1.00 | — | — | 1.00 | — | — | ||||||||
| Hi-res mismatch | 260 | 0.77 | (0.39, 1.50) | .44 | 1.29 | (1.02, 1.62) | .03 | 1.34 | (1.04, 1.74) | 0.03 | 1.21 | (1.02, 1.44) | |||||||||
| Low-res mismatch | 51 | 1.61 | (0.28, 9.26) | .59 | 1.42 | (0.88, 2.29) | .15 | 0.71 | (0.32, 1.57) | 0.40 | 1.64 | (1.13, 2.38) | .009 | ||||||||
. | . | Engraftment . | . | . | Grade III-IV acute GVHD . | . | . | Chronic GVHD . | . | . | Mortality . | . | . | ||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Locus . | No. . | OR . | 95% CI . | P . | RR . | 95% CI . | P . | RR . | 95% CI . | P . | RR . | 95% CI . | P . | ||||||||
| HLA-A match | 1500 | 1.00 | — | — | 1.00 | — | — | 1.00 | — | — | 1.00 | — | — | ||||||||
| Hi-res mismatch | 157 | 0.95 | (0.40, 2.26) | .91 | 1.31 | (1.00, 1.70) | .05 | 1.25 | (0.91, 1.70) | .17 | 1.26 | (1.02, 1.55) | .03 | ||||||||
| Low-res mismatch | 217 | 0.51 | (0.24, 1.08) | .08 | 1.51 | (1.18, 1.95) | .001 | 1.42 | (1.09, 1.85) | .01 | 1.44 | (1.20, 1.74) | < .0001 | ||||||||
| HLA-B match | 1397 | 1.00 | — | — | 1.00 | — | — | 1.00 | — | — | 1.00 | — | — | ||||||||
| Hi-res mismatch | 270 | 1.66 | (0.75, 3.69) | .22 | 1.13 | (0.91, 1.42) | .27 | 1.07 | (0.83, 1.38) | .58 | 1.08 | (0.90, 1.28) | .41 | ||||||||
| Low-res mismatch | 207 | 0.72 | (0.34, 1.49) | .37 | 1.35 | (1.03, 1.76) | .03 | 0.95 | (0.68, 1.32) | .74 | 1.46 | (1.19, 1.80) | .0003 | ||||||||
| HLA-C match | 1125 | 1.00 | — | — | 1.00 | — | — | 1.00 | — | — | 1.00 | — | — | ||||||||
| Hi-res mismatch | 83 | 0.80 | (0.29, 2.24) | .68 | 0.83 | (0.58, 1.20) | .32 | 0.93 | (0.65, 1.32) | .66 | 0.96 | (0.72, 1.29) | .78 | ||||||||
| Low-res mismatch | 666 | 0.54 | (0.31, 0.93) | .03 | 1.24 | (1.03, 1.50) | .02 | 1.05 | (0.86, 1.28) | .61 | 1.21 | (1.06, 1.40) | .007 | ||||||||
| HLA-DRB1 match | 1563 | 1.00 | — | — | 1.00 | — | — | 1.00 | — | — | 1.00 | — | — | ||||||||
| Hi-res mismatch | 260 | 0.77 | (0.39, 1.50) | .44 | 1.29 | (1.02, 1.62) | .03 | 1.34 | (1.04, 1.74) | 0.03 | 1.21 | (1.02, 1.44) | |||||||||
| Low-res mismatch | 51 | 1.61 | (0.28, 9.26) | .59 | 1.42 | (0.88, 2.29) | .15 | 0.71 | (0.32, 1.57) | 0.40 | 1.64 | (1.13, 2.38) | .009 | ||||||||
Shown are results of multivariate analysis including odds ratio (OR) for engraftment and relative risk (RR) for GVHD and mortality, 95% confidence intervals (CI), and P values associated with mismatching at each locus. Statistically significant associations are shown in boldface. Low- but not high-resolution mismatching for HLA-A adversely affected acute GVHD, chronic GVHD, and mortality, whereas low-resolution mismatch for HLA-B, -C, and -DR showed significant effects on mortality. Similar adverse relative risks and trends (.01 < P < .05) were noted also with high-resolution mismatch at HLA-A for acute GVHD and mortality, HLA-DR for acute GVHD, chronic GVHD and mortality. Low-resolution but not high-resolution mismatching demonstrated trends toward adverse effects for HLA-B on acute GVHD and for HLA-C on engraftment and acute GVHD. Res indicates resolution.