Response and clonal evolution. (A) Response rates to IST regimens in HLA alloimmunized patients compared to nonalloimmunized patients separated out by the degree of response. Total number of patients n = 430. Response to IST in HLA alloimmunized (positive) patients (48/85; 57%) and HLA nonalloimmunized (negative) patients (252/345; 73%); P = .004. (B) Alluvial plots of the improvement in response between 3-month and 6-month time points in HLA alloimmunized vs nonalloimmunized patients. (C) Kaplan-Meier curves depicting statistically significant difference in the risk of clonal evolution based on HLA alloimmunization status; P= .03. NE, not evaluable; NR, no response.