Clinical significance of subcategory and severity of chronic graft-versus-host disease evaluated by National Institutes of Health consensus criteria
To evaluate the clinical significance of subcategory and severity of chronic graft-versus-host disease (GVHD) as defined by the National Institutes of Health (NIH) consensus criteria, we retrospectively studied 211 patients with hematologic neoplasms who survived beyond 100 days after allogeneic hem...
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| Veröffentlicht in: | International journal of hematology 2011-04, Vol.93 (4), p.532-541 |
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| container_title | International journal of hematology |
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| creator | Sato, Takayuki Ichinohe, Tatsuo Kanda, Junya Yamashita, Kouhei Kondo, Tadakazu Ishikawa, Takayuki Uchiyama, Takashi Takaori-Kondo, Akifumi |
| description | To evaluate the clinical significance of subcategory and severity of chronic graft-versus-host disease (GVHD) as defined by the National Institutes of Health (NIH) consensus criteria, we retrospectively studied 211 patients with hematologic neoplasms who survived beyond 100 days after allogeneic hematopoietic cell transplantation. Endpoints included chronic GVHD-specific survival (cGSS), duration of immunosuppressive treatment, and non-relapse mortality (NRM). A total of 96 patients fulfilled the NIH diagnostic criteria for cGVHD. In univariable analysis, patients with NIH overlap syndrome tended to exhibit lower cGSS compared to those with NIH classic cGVHD [hazard ratio (HR) = 2.76,
P
= 0.060], while patients with severe cGVHD at onset had a significantly lower cGSS compared to those with mild-to-moderate cGVHD (HR = 3.10,
P
= 0.034). The duration of immunosuppressive treatment was not significantly affected by either subcategory or severity of NIH cGVHD. In multivariable analysis treating cGVHD as a time-dependent covariate, development of overlap syndrome (HR = 3.90,
P
= 0.014) or severe cGVHD at peak worsening (HR = 6.21,
P
< 0.001) was significantly associated with higher risk of NRM compared to the absence of cGVHD. Our results suggest that both the subcategory and severity of NIH cGVHD are partly correlated with cGSS and may play a useful role in distinguishing patients at high risk for NRM, warranting validation of this approach through future prospective studies. |
| doi_str_mv | 10.1007/s12185-011-0820-0 |
| format | Article |
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P
= 0.060], while patients with severe cGVHD at onset had a significantly lower cGSS compared to those with mild-to-moderate cGVHD (HR = 3.10,
P
= 0.034). The duration of immunosuppressive treatment was not significantly affected by either subcategory or severity of NIH cGVHD. In multivariable analysis treating cGVHD as a time-dependent covariate, development of overlap syndrome (HR = 3.90,
P
= 0.014) or severe cGVHD at peak worsening (HR = 6.21,
P
< 0.001) was significantly associated with higher risk of NRM compared to the absence of cGVHD. Our results suggest that both the subcategory and severity of NIH cGVHD are partly correlated with cGSS and may play a useful role in distinguishing patients at high risk for NRM, warranting validation of this approach through future prospective studies.</description><identifier>ISSN: 0925-5710</identifier><identifier>EISSN: 1865-3774</identifier><identifier>DOI: 10.1007/s12185-011-0820-0</identifier><identifier>PMID: 21465116</identifier><language>eng</language><publisher>Tokyo: Springer Japan</publisher><subject>Adolescent ; Adult ; Aged ; Biological and medical sciences ; Chronic Disease ; Consensus ; Female ; Graft vs Host Disease - drug therapy ; Graft vs Host Disease - pathology ; Graft vs Host Disease - prevention & control ; Hematologic and hematopoietic diseases ; Hematologic Neoplasms - surgery ; Hematology ; Hematopoietic Stem Cell Transplantation - adverse effects ; Humans ; Immunosuppressive Agents - therapeutic use ; Male ; Medical sciences ; Medicine ; Medicine & Public Health ; Middle Aged ; National Institutes of Health (U.S.) - standards ; Oncology ; Original Article ; Recurrence ; Retrospective Studies ; Severity of Illness Index ; United States ; Young Adult</subject><ispartof>International journal of hematology, 2011-04, Vol.93 (4), p.532-541</ispartof><rights>The Japanese Society of Hematology 2011</rights><rights>2015 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c495t-54318f2d9db42fdeca8c8fdc3fc06b184b85dd46063781a837b140deb90b61bc3</citedby><cites>FETCH-LOGICAL-c495t-54318f2d9db42fdeca8c8fdc3fc06b184b85dd46063781a837b140deb90b61bc3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s12185-011-0820-0$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s12185-011-0820-0$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27903,27904,41467,42536,51297</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=24550659$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/21465116$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Sato, Takayuki</creatorcontrib><creatorcontrib>Ichinohe, Tatsuo</creatorcontrib><creatorcontrib>Kanda, Junya</creatorcontrib><creatorcontrib>Yamashita, Kouhei</creatorcontrib><creatorcontrib>Kondo, Tadakazu</creatorcontrib><creatorcontrib>Ishikawa, Takayuki</creatorcontrib><creatorcontrib>Uchiyama, Takashi</creatorcontrib><creatorcontrib>Takaori-Kondo, Akifumi</creatorcontrib><title>Clinical significance of subcategory and severity of chronic graft-versus-host disease evaluated by National Institutes of Health consensus criteria</title><title>International journal of hematology</title><addtitle>Int J Hematol</addtitle><addtitle>Int J Hematol</addtitle><description>To evaluate the clinical significance of subcategory and severity of chronic graft-versus-host disease (GVHD) as defined by the National Institutes of Health (NIH) consensus criteria, we retrospectively studied 211 patients with hematologic neoplasms who survived beyond 100 days after allogeneic hematopoietic cell transplantation. Endpoints included chronic GVHD-specific survival (cGSS), duration of immunosuppressive treatment, and non-relapse mortality (NRM). A total of 96 patients fulfilled the NIH diagnostic criteria for cGVHD. In univariable analysis, patients with NIH overlap syndrome tended to exhibit lower cGSS compared to those with NIH classic cGVHD [hazard ratio (HR) = 2.76,
P
= 0.060], while patients with severe cGVHD at onset had a significantly lower cGSS compared to those with mild-to-moderate cGVHD (HR = 3.10,
P
= 0.034). The duration of immunosuppressive treatment was not significantly affected by either subcategory or severity of NIH cGVHD. In multivariable analysis treating cGVHD as a time-dependent covariate, development of overlap syndrome (HR = 3.90,
P
= 0.014) or severe cGVHD at peak worsening (HR = 6.21,
P
< 0.001) was significantly associated with higher risk of NRM compared to the absence of cGVHD. Our results suggest that both the subcategory and severity of NIH cGVHD are partly correlated with cGSS and may play a useful role in distinguishing patients at high risk for NRM, warranting validation of this approach through future prospective studies.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Aged</subject><subject>Biological and medical sciences</subject><subject>Chronic Disease</subject><subject>Consensus</subject><subject>Female</subject><subject>Graft vs Host Disease - drug therapy</subject><subject>Graft vs Host Disease - pathology</subject><subject>Graft vs Host Disease - prevention & control</subject><subject>Hematologic and hematopoietic diseases</subject><subject>Hematologic Neoplasms - surgery</subject><subject>Hematology</subject><subject>Hematopoietic Stem Cell Transplantation - adverse effects</subject><subject>Humans</subject><subject>Immunosuppressive Agents - therapeutic use</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>National Institutes of Health (U.S.) - standards</subject><subject>Oncology</subject><subject>Original Article</subject><subject>Recurrence</subject><subject>Retrospective Studies</subject><subject>Severity of Illness Index</subject><subject>United States</subject><subject>Young Adult</subject><issn>0925-5710</issn><issn>1865-3774</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2011</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNp1kctuFDEQRS0EIkPgA9ggC4mlwdXtVy_RKJBIEWxg3fJzxlGnO7jckeY_-GA8moGsWLnkOvdWqS4hb4F_BM71J4QOjGQcgHHTccafkQ0YJVmvtXhONnzoJJMa-AV5hXjHOWgu9Ety0YFQEkBtyO_tlOfs7UQx7-acWjn7SJdEcXXe1rhbyoHaOVCMj7Hkejj2_L4sTUV3xabK2j-uyPYLVhoyRouRxkc7rU0eqDvQb7bmZW4zbmasua414tHlOtqp7qlfZoxzc6C--bcZ9jV5keyE8c35vSQ_v1z92F6z2-9fb7afb5kXg6xMih5M6sIQnOhSiN4ab1LwffJcOTDCGRmCUFz12oA1vXYgeIhu4E6B8_0leX_yfSjLrzViHe-WtbRFcTSqG0CbTjUITpAvC2KJaXwo-d6Wwwh8PMYwnmIYWwzjMYaRN827s_Hq7mP4p_h79wZ8OAMW2_FTaVfP-MQJKbmSQ-O6E4etNe9iedrw_9P_AMBfoy0</recordid><startdate>20110401</startdate><enddate>20110401</enddate><creator>Sato, Takayuki</creator><creator>Ichinohe, Tatsuo</creator><creator>Kanda, Junya</creator><creator>Yamashita, Kouhei</creator><creator>Kondo, Tadakazu</creator><creator>Ishikawa, Takayuki</creator><creator>Uchiyama, Takashi</creator><creator>Takaori-Kondo, Akifumi</creator><general>Springer Japan</general><general>Springer</general><general>Springer Nature B.V</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7T5</scope><scope>7T7</scope><scope>7TM</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FD</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>C1K</scope><scope>CCPQU</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>H94</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope></search><sort><creationdate>20110401</creationdate><title>Clinical significance of subcategory and severity of chronic graft-versus-host disease evaluated by National Institutes of Health consensus criteria</title><author>Sato, Takayuki ; Ichinohe, Tatsuo ; Kanda, Junya ; Yamashita, Kouhei ; Kondo, Tadakazu ; Ishikawa, Takayuki ; Uchiyama, Takashi ; Takaori-Kondo, Akifumi</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c495t-54318f2d9db42fdeca8c8fdc3fc06b184b85dd46063781a837b140deb90b61bc3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2011</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Aged</topic><topic>Biological and medical sciences</topic><topic>Chronic Disease</topic><topic>Consensus</topic><topic>Female</topic><topic>Graft vs Host Disease - drug therapy</topic><topic>Graft vs Host Disease - pathology</topic><topic>Graft vs Host Disease - prevention & control</topic><topic>Hematologic and hematopoietic diseases</topic><topic>Hematologic Neoplasms - surgery</topic><topic>Hematology</topic><topic>Hematopoietic Stem Cell Transplantation - adverse effects</topic><topic>Humans</topic><topic>Immunosuppressive Agents - therapeutic use</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>National Institutes of Health (U.S.) - standards</topic><topic>Oncology</topic><topic>Original Article</topic><topic>Recurrence</topic><topic>Retrospective Studies</topic><topic>Severity of Illness Index</topic><topic>United States</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Sato, Takayuki</creatorcontrib><creatorcontrib>Ichinohe, Tatsuo</creatorcontrib><creatorcontrib>Kanda, Junya</creatorcontrib><creatorcontrib>Yamashita, Kouhei</creatorcontrib><creatorcontrib>Kondo, Tadakazu</creatorcontrib><creatorcontrib>Ishikawa, Takayuki</creatorcontrib><creatorcontrib>Uchiyama, Takashi</creatorcontrib><creatorcontrib>Takaori-Kondo, Akifumi</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Immunology Abstracts</collection><collection>Industrial and Applied Microbiology Abstracts (Microbiology A)</collection><collection>Nucleic Acids Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Technology Research Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>Environmental Sciences and Pollution Management</collection><collection>ProQuest One Community College</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Nursing & Allied Health Premium</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><jtitle>International journal of hematology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Sato, Takayuki</au><au>Ichinohe, Tatsuo</au><au>Kanda, Junya</au><au>Yamashita, Kouhei</au><au>Kondo, Tadakazu</au><au>Ishikawa, Takayuki</au><au>Uchiyama, Takashi</au><au>Takaori-Kondo, Akifumi</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Clinical significance of subcategory and severity of chronic graft-versus-host disease evaluated by National Institutes of Health consensus criteria</atitle><jtitle>International journal of hematology</jtitle><stitle>Int J Hematol</stitle><addtitle>Int J Hematol</addtitle><date>2011-04-01</date><risdate>2011</risdate><volume>93</volume><issue>4</issue><spage>532</spage><epage>541</epage><pages>532-541</pages><issn>0925-5710</issn><eissn>1865-3774</eissn><abstract>To evaluate the clinical significance of subcategory and severity of chronic graft-versus-host disease (GVHD) as defined by the National Institutes of Health (NIH) consensus criteria, we retrospectively studied 211 patients with hematologic neoplasms who survived beyond 100 days after allogeneic hematopoietic cell transplantation. Endpoints included chronic GVHD-specific survival (cGSS), duration of immunosuppressive treatment, and non-relapse mortality (NRM). A total of 96 patients fulfilled the NIH diagnostic criteria for cGVHD. In univariable analysis, patients with NIH overlap syndrome tended to exhibit lower cGSS compared to those with NIH classic cGVHD [hazard ratio (HR) = 2.76,
P
= 0.060], while patients with severe cGVHD at onset had a significantly lower cGSS compared to those with mild-to-moderate cGVHD (HR = 3.10,
P
= 0.034). The duration of immunosuppressive treatment was not significantly affected by either subcategory or severity of NIH cGVHD. In multivariable analysis treating cGVHD as a time-dependent covariate, development of overlap syndrome (HR = 3.90,
P
= 0.014) or severe cGVHD at peak worsening (HR = 6.21,
P
< 0.001) was significantly associated with higher risk of NRM compared to the absence of cGVHD. Our results suggest that both the subcategory and severity of NIH cGVHD are partly correlated with cGSS and may play a useful role in distinguishing patients at high risk for NRM, warranting validation of this approach through future prospective studies.</abstract><cop>Tokyo</cop><pub>Springer Japan</pub><pmid>21465116</pmid><doi>10.1007/s12185-011-0820-0</doi><tpages>10</tpages></addata></record> |
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| subjects | Adolescent Adult Aged Biological and medical sciences Chronic Disease Consensus Female Graft vs Host Disease - drug therapy Graft vs Host Disease - pathology Graft vs Host Disease - prevention & control Hematologic and hematopoietic diseases Hematologic Neoplasms - surgery Hematology Hematopoietic Stem Cell Transplantation - adverse effects Humans Immunosuppressive Agents - therapeutic use Male Medical sciences Medicine Medicine & Public Health Middle Aged National Institutes of Health (U.S.) - standards Oncology Original Article Recurrence Retrospective Studies Severity of Illness Index United States Young Adult |
| title | Clinical significance of subcategory and severity of chronic graft-versus-host disease evaluated by National Institutes of Health consensus criteria |
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