Article
Evaluation of prognostic factors among patients with chronic graft-versus-host disease
Author/s | Pérez Simón, José Antonio
Afram, Gabriel Martino, Rodrigo Piñana, José L. Caballero Velázquez, Teresa Ringden, Olle Valcárcel, D. Caballero, Dolores Remberger, Mats De Paz, Yanira Sierra, Jordi San Miguel, Jesús Hagglund, Hans |
Director | |
Department | Universidad de Sevilla. Departamento de Medicina |
Publication Date | 2011 |
Deposit Date | 2022-02-09 |
Published in |
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Abstract | Background: Chronic graft-versus-host disease (cGVHD) is a major complication after allogeneic stem cell transplantation with an adverse effect on both mortality and morbidity. In 2005, the National Institute of Health ... Background: Chronic graft-versus-host disease (cGVHD) is a major complication after allogeneic stem cell transplantation with an adverse effect on 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 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 histories. Results: As far as the new sub-categories are concerned, in univariate analysis diagnosis of overlap syndrome adversely affected the outcome. Also, the number of organs involved for a cut-off value of 4 significantly influenced 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 outcome. These 3 variables allowed us to develop a simple score system which identifies 4 subgroups of patients with 84%, 64%, 43% and 0% overall survival at five years after cGVHD diagnosis (score 0: HR=15.96 (95% CI: 6.85-37.17), P<0.001; score 1: HR=5.47 (95% CI: 2.6-11.5), P<0.001; score 2: HR=2.8 (95% CI: 1.32-5.93), P=0.007). Conclusions: In summary, we have identified a powerful and simple tool to discriminate different subgroups of patients in terms of chronic graft-versus-host disease related mortality and survival. |
Citation | Pérez Simón, J.A., Afram, G., Martino, R., Piñana, J.L., Caballero Velázquez, T., Ringden, O.,...,Hagglund, H. (2011). Evaluation of prognostic factors among patients with chronic graft-versus-host disease. Haematologica, 97 (8), 1187-1195. |
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