| Evaluation of prognostic factors among patients with chronic graft-versus-host disease. | |
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MedLine Citation:
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PMID: 22371184 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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Abstract. Background. Chronic graft-versus-host disease (cGVHD) is a major complication after allogeneic stem cell transplantation adversely affecting both mortality and morbidity. In 2005 the National Institute of Health proposed new criteria for diagnosis and classification of chronic graft-versus-host disease for clinical trials. New sub-categories were recognized such as late-onset acute graft-versus-host disease and overlap syndrome. Design and Methods. We have evaluated the prognostic impact of the new sub-categories as well as the clinical scoring system proposed by the National Institute of Health in a retrospective, multicenter study of 820 patients undergoing allogeneic stem cell transplantation between 2000 and 2006 at 3 different institutions. Patients were retrospectively categorized according to the National Institute of Health criteria from patients' medical history. Results. Regarding the new sub-cathegories, diagnosis of overlap syndrome adversely affected the outcome in univariate analysis. Also the number of organs involved for a cut-off value of 4 significantly influenced on both cGVHD related mortality and survival. In multivariate analysis, in addition to NIH score, platelet count and performance score at the time of cGVHD diagnosis plus gut involvement significantly influenced on outcome. These 3 variables allowed to develop a simple score system which identifies 4 sub-groups of patients with 84%, 64%, 43% and 0% overall survival al 5 years after cGVHD diagnosis. HR= 15.96 (95% CI: 6.85-37.17), p<0.001 for score 0, HR= 5.47 (95% CI: 2.6-11.5), p<0.001 for score 1 and HR= 2.8 (95% CI: 1.32-5.93), p=0.007 for score 2. Conclusions. In summary, we have identified a powerful and simple tool to identify different subgroups of patients in terms of chronic graft-versus-host disease-related mortality and survival. |
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Authors:
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Jose' Antonio Perez Simon; Gabriel Nino Afram; Rodrigo Martino; Jose L Pinana; Teresa Caballero-Velazquez; Olle Ringden; David Valcarel; Dolores Caballero; Mats Remberger; Yanira de Paz; Jorge Sierra; Jesus F San Miguel; Hans Hagglund |
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Publication Detail:
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Type: JOURNAL ARTICLE Date: 2012-2-27 |
Journal Detail:
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Title: Haematologica Volume: - ISSN: 1592-8721 ISO Abbreviation: - Publication Date: 2012 Feb |
Date Detail:
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Created Date: 2012-2-28 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0417435 Medline TA: Haematologica Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Affiliation:
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Hospital Universitario de Salamanca, Spain; |
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