Prevalence and risk factors associated with development of ocular GVHD defined by NIH consensus criteria
We studied 172 patients for development of ocular graft-versus-host disease (GVHD) after allogeneic stem cell transplantation (allo-SCT) from 2002 to 2009. Ocular GVHD was diagnosed in 60 patients (38%), with 27 (16%) being diagnosed at days 100 and 33 (23%) beyond day 100 for a 2-year cumulative in...
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| creator | Jacobs, R Tran, U Chen, H Kassim, A Engelhardt, B G Greer, J P Goodman, S G Clifton, C Lucid, C Vaughan, L A Savani, B N Jagasia, M |
| description | We studied 172 patients for development of ocular graft-versus-host disease (GVHD) after allogeneic stem cell transplantation (allo-SCT) from 2002 to 2009. Ocular GVHD was diagnosed in 60 patients (38%), with 27 (16%) being diagnosed at days 100 and 33 (23%) beyond day 100 for a 2-year cumulative incidence of 35% (95% confidence interval (CI), 28–43). The positive and negative predictive values of a Schirmer I test score (using ⩽5 mm as a cutoff) in predicting ocular GVHD (day 100) were 41 and 82%, respectively. In patients with ocular GVHD beyond day 100, extraocular manifestations of GVHD preceded the development of ocular GVHD in most patients (27 of 33, 81%). Prior acute skin GVHD (odds ratio 2.57, 95% CI 1.17–5.64,
P
=0.019) and male recipients of female donors (odds ratio 2.57, 95% CI 1.09–6.06,
P
=0.03) were independent risk factors for ocular GVHD. We recommend comprehensive ocular evaluation rather than a screening Schirmer's test to establish the diagnosis of ocular GVHD. Early diagnosis and preventive strategies in high-risk populations need to be studied in clinical trials to prevent devastating impact on quality of life in patients with prolonged ocular GVHD. |
| doi_str_mv | 10.1038/bmt.2012.56 |
| format | Article |
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P
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P
=0.03) were independent risk factors for ocular GVHD. We recommend comprehensive ocular evaluation rather than a screening Schirmer's test to establish the diagnosis of ocular GVHD. Early diagnosis and preventive strategies in high-risk populations need to be studied in clinical trials to prevent devastating impact on quality of life in patients with prolonged ocular GVHD.</description><identifier>ISSN: 0268-3369</identifier><identifier>EISSN: 1476-5365</identifier><identifier>DOI: 10.1038/bmt.2012.56</identifier><identifier>PMID: 22484321</identifier><identifier>CODEN: BMTRE9</identifier><language>eng</language><publisher>London: Nature Publishing Group UK</publisher><subject>631/250/1904 ; 692/499 ; 692/699/249/1529 ; 692/700/478/174 ; Adult ; Aged ; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy ; Biological and medical sciences ; Bone marrow ; Bone marrow transplantation ; Bone marrow, stem cells transplantation. Graft versus host reaction ; Cell Biology ; Clinical trials ; Confidence intervals ; Consensus Development Conferences, NIH as Topic ; Demographic aspects ; Diagnosis ; Distribution ; Donors ; Dry Eye Syndromes - epidemiology ; Dry Eye Syndromes - etiology ; Eye Diseases - epidemiology ; Eye Diseases - etiology ; Eye infections ; Female ; Graft versus host disease ; Graft versus host reaction ; Graft vs Host Disease - epidemiology ; Graft vs Host Disease - etiology ; Hematology ; Hematopoietic Stem Cell Transplantation - adverse effects ; Hematopoietic Stem Cell Transplantation - statistics & numerical data ; Humans ; Internal Medicine ; Male ; Medical sciences ; Medicine ; Medicine & Public Health ; Middle Aged ; National Institutes of Health (U.S.) ; original-article ; Patients ; Population studies ; Prevalence ; Public Health ; Quality of life ; Risk analysis ; Risk Factors ; Risk groups ; Skin ; Stem cell transplantation ; Stem Cells ; Transfusions. Complications. Transfusion reactions. Cell and gene therapy ; Transplantation ; United States - epidemiology ; Young Adult</subject><ispartof>Bone marrow transplantation (Basingstoke), 2012-11, Vol.47 (11), p.1470-1473</ispartof><rights>Macmillan Publishers Limited 2012</rights><rights>2014 INIST-CNRS</rights><rights>COPYRIGHT 2012 Nature Publishing Group</rights><rights>Copyright Nature Publishing Group Nov 2012</rights><rights>Macmillan Publishers Limited 2012.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c574t-fc82c6668368ad7479596586ffc021b1c23a7d4e529180c943b98cf592e9fc423</citedby><cites>FETCH-LOGICAL-c574t-fc82c6668368ad7479596586ffc021b1c23a7d4e529180c943b98cf592e9fc423</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1038/bmt.2012.56$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1038/bmt.2012.56$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=26641420$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/22484321$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Jacobs, R</creatorcontrib><creatorcontrib>Tran, U</creatorcontrib><creatorcontrib>Chen, H</creatorcontrib><creatorcontrib>Kassim, A</creatorcontrib><creatorcontrib>Engelhardt, B G</creatorcontrib><creatorcontrib>Greer, J P</creatorcontrib><creatorcontrib>Goodman, S G</creatorcontrib><creatorcontrib>Clifton, C</creatorcontrib><creatorcontrib>Lucid, C</creatorcontrib><creatorcontrib>Vaughan, L A</creatorcontrib><creatorcontrib>Savani, B N</creatorcontrib><creatorcontrib>Jagasia, M</creatorcontrib><title>Prevalence and risk factors associated with development of ocular GVHD defined by NIH consensus criteria</title><title>Bone marrow transplantation (Basingstoke)</title><addtitle>Bone Marrow Transplant</addtitle><addtitle>Bone Marrow Transplant</addtitle><description>We studied 172 patients for development of ocular graft-versus-host disease (GVHD) after allogeneic stem cell transplantation (allo-SCT) from 2002 to 2009. Ocular GVHD was diagnosed in 60 patients (38%), with 27 (16%) being diagnosed at days 100 and 33 (23%) beyond day 100 for a 2-year cumulative incidence of 35% (95% confidence interval (CI), 28–43). The positive and negative predictive values of a Schirmer I test score (using ⩽5 mm as a cutoff) in predicting ocular GVHD (day 100) were 41 and 82%, respectively. In patients with ocular GVHD beyond day 100, extraocular manifestations of GVHD preceded the development of ocular GVHD in most patients (27 of 33, 81%). Prior acute skin GVHD (odds ratio 2.57, 95% CI 1.17–5.64,
P
=0.019) and male recipients of female donors (odds ratio 2.57, 95% CI 1.09–6.06,
P
=0.03) were independent risk factors for ocular GVHD. We recommend comprehensive ocular evaluation rather than a screening Schirmer's test to establish the diagnosis of ocular GVHD. Early diagnosis and preventive strategies in high-risk populations need to be studied in clinical trials to prevent devastating impact on quality of life in patients with prolonged ocular GVHD.</description><subject>631/250/1904</subject><subject>692/499</subject><subject>692/699/249/1529</subject><subject>692/700/478/174</subject><subject>Adult</subject><subject>Aged</subject><subject>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy</subject><subject>Biological and medical sciences</subject><subject>Bone marrow</subject><subject>Bone marrow transplantation</subject><subject>Bone marrow, stem cells transplantation. Graft versus host reaction</subject><subject>Cell Biology</subject><subject>Clinical trials</subject><subject>Confidence intervals</subject><subject>Consensus Development Conferences, NIH as Topic</subject><subject>Demographic aspects</subject><subject>Diagnosis</subject><subject>Distribution</subject><subject>Donors</subject><subject>Dry Eye Syndromes - epidemiology</subject><subject>Dry Eye Syndromes - etiology</subject><subject>Eye Diseases - epidemiology</subject><subject>Eye Diseases - etiology</subject><subject>Eye infections</subject><subject>Female</subject><subject>Graft versus host disease</subject><subject>Graft versus host reaction</subject><subject>Graft vs Host Disease - epidemiology</subject><subject>Graft vs Host Disease - etiology</subject><subject>Hematology</subject><subject>Hematopoietic Stem Cell Transplantation - adverse effects</subject><subject>Hematopoietic Stem Cell Transplantation - statistics & numerical data</subject><subject>Humans</subject><subject>Internal Medicine</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.)</subject><subject>original-article</subject><subject>Patients</subject><subject>Population studies</subject><subject>Prevalence</subject><subject>Public Health</subject><subject>Quality of life</subject><subject>Risk analysis</subject><subject>Risk Factors</subject><subject>Risk groups</subject><subject>Skin</subject><subject>Stem cell transplantation</subject><subject>Stem Cells</subject><subject>Transfusions. Complications. Transfusion reactions. 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Intensive care medicine. Transfusions. Cell therapy and gene therapy</topic><topic>Biological and medical sciences</topic><topic>Bone marrow</topic><topic>Bone marrow transplantation</topic><topic>Bone marrow, stem cells transplantation. Graft versus host reaction</topic><topic>Cell Biology</topic><topic>Clinical trials</topic><topic>Confidence intervals</topic><topic>Consensus Development Conferences, NIH as Topic</topic><topic>Demographic aspects</topic><topic>Diagnosis</topic><topic>Distribution</topic><topic>Donors</topic><topic>Dry Eye Syndromes - epidemiology</topic><topic>Dry Eye Syndromes - etiology</topic><topic>Eye Diseases - epidemiology</topic><topic>Eye Diseases - etiology</topic><topic>Eye infections</topic><topic>Female</topic><topic>Graft versus host disease</topic><topic>Graft versus host reaction</topic><topic>Graft vs Host Disease - epidemiology</topic><topic>Graft vs Host Disease - etiology</topic><topic>Hematology</topic><topic>Hematopoietic Stem Cell Transplantation - adverse effects</topic><topic>Hematopoietic Stem Cell Transplantation - statistics & numerical data</topic><topic>Humans</topic><topic>Internal Medicine</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.)</topic><topic>original-article</topic><topic>Patients</topic><topic>Population studies</topic><topic>Prevalence</topic><topic>Public Health</topic><topic>Quality of life</topic><topic>Risk analysis</topic><topic>Risk Factors</topic><topic>Risk groups</topic><topic>Skin</topic><topic>Stem cell transplantation</topic><topic>Stem Cells</topic><topic>Transfusions. 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Ocular GVHD was diagnosed in 60 patients (38%), with 27 (16%) being diagnosed at days 100 and 33 (23%) beyond day 100 for a 2-year cumulative incidence of 35% (95% confidence interval (CI), 28–43). The positive and negative predictive values of a Schirmer I test score (using ⩽5 mm as a cutoff) in predicting ocular GVHD (day 100) were 41 and 82%, respectively. In patients with ocular GVHD beyond day 100, extraocular manifestations of GVHD preceded the development of ocular GVHD in most patients (27 of 33, 81%). Prior acute skin GVHD (odds ratio 2.57, 95% CI 1.17–5.64,
P
=0.019) and male recipients of female donors (odds ratio 2.57, 95% CI 1.09–6.06,
P
=0.03) were independent risk factors for ocular GVHD. We recommend comprehensive ocular evaluation rather than a screening Schirmer's test to establish the diagnosis of ocular GVHD. Early diagnosis and preventive strategies in high-risk populations need to be studied in clinical trials to prevent devastating impact on quality of life in patients with prolonged ocular GVHD.</abstract><cop>London</cop><pub>Nature Publishing Group UK</pub><pmid>22484321</pmid><doi>10.1038/bmt.2012.56</doi><tpages>4</tpages><oa>free_for_read</oa></addata></record> |
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| issn | 0268-3369 1476-5365 |
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| source | MEDLINE; Springer Nature - Complete Springer Journals; Nature Journals Online; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals |
| subjects | 631/250/1904 692/499 692/699/249/1529 692/700/478/174 Adult Aged Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy Biological and medical sciences Bone marrow Bone marrow transplantation Bone marrow, stem cells transplantation. Graft versus host reaction Cell Biology Clinical trials Confidence intervals Consensus Development Conferences, NIH as Topic Demographic aspects Diagnosis Distribution Donors Dry Eye Syndromes - epidemiology Dry Eye Syndromes - etiology Eye Diseases - epidemiology Eye Diseases - etiology Eye infections Female Graft versus host disease Graft versus host reaction Graft vs Host Disease - epidemiology Graft vs Host Disease - etiology Hematology Hematopoietic Stem Cell Transplantation - adverse effects Hematopoietic Stem Cell Transplantation - statistics & numerical data Humans Internal Medicine Male Medical sciences Medicine Medicine & Public Health Middle Aged National Institutes of Health (U.S.) original-article Patients Population studies Prevalence Public Health Quality of life Risk analysis Risk Factors Risk groups Skin Stem cell transplantation Stem Cells Transfusions. Complications. Transfusion reactions. Cell and gene therapy Transplantation United States - epidemiology Young Adult |
| title | Prevalence and risk factors associated with development of ocular GVHD defined by NIH consensus criteria |
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