Global and organ-specific chronic graft-versus-host disease severity according to the 2005 NIH Consensus Criteria.

Publication Type:

Journal Article

Source:

Blood, Volume 118, Issue 15, p.4242-4249 (2011)

Keywords:

2011, Adult, Aged, Center-Authored Paper, Chronic Disease, Clinical Research Division, Consensus Development Conferences, NIH as Topic, Disease-Free Survival, Female, Graft vs Host Disease/, hematopoietic stem cell transplantation, Humans, Male, Middle Aged, Organ Specificity, Prospective Studies, Research Trials Office Core Facility - Biostatistics Service, Risk Factors, September 2011, Severity of Illness Index, Shared Resources, Survival Rate, Transplantation, Homologous, United States

Abstract:

In 2005, the National Institutes of Health Consensus Development Project on Criteria for Clinical Trials in Chronic graft-versus-host disease (GVHD) proposed a new scoring system for individual organs and an algorithm for calculating global severity (mild, moderate, severe). The Chronic GVHD Consortium was established to test these new criteria. This report includes the first 298 adult patients enrolled at 5 centers of the Consortium. Patients were assessed every 3-6 months using standardized forms recommended by the Consensus Conference. At the time of study enrollment, global chronic GVHD severity was mild in 10% (n=32), moderate in 59% (n=175) and severe in 31% (n=91). Skin, lung or eye scores determined the global severity score in the majority of cases, with the other five organs determining 16% of the global severity scores. Conventional risk factors predictive for onset of chronic GVHD and non-relapse mortality in people with chronic GVHD were not associated with NIH global severity scores. Global severity scores at enrollment were associated with non-relapse mortality (p<0.0001) and survival (p<0.0001); two year overall survival was 62% (severe), 86% (moderate) and 97% (mild). Patients with mild chronic GVHD have a good prognosis, while patients with severe chronic GVHD have a poor prognosis. This study was registered at www.clinicaltrials.gov as #NCT00637689.