Yazarlar : Inamoto Y, Martin P, Storer B et al

Yayın : Haematologica

Yayın Yılı : 2014

Pubmed Linki : http://www.docguide.com/association-organ-severity-mortality-and-recurrent-malignancy-chronic-graft-versus-host-disease?tsid=5

Konu : Diğer

Literatür İçeriği :  The National Institutes of Health global score for chronic graft-versus-host disease was devised by experts but was not based on empirical data. We hypothesized that analysis of prospectively collected data would allow derivation of a more accurate model for estimating mortality risk. We analyzed 574 adult patients with chronic graft-versus-host disease enrolled in a multicenter, observational study, using multivariate time-varying analysis accounting for serial changes in severity of eight individual organ sites over time. In the training set, severity of skin, mouth, gastrointestinal tract, liver and lung involvement were independently associated with the risk of nonrelapse mortality. Weighted mortality points were assigned to individual organs based on the hazard ratios and were summed. The population was divided into three risk groups based on the total mortality points. The three new risk groups were validated in an independent validation set, but did not show better discriminative performance than the National Institutes of Health global score. As compared to moderate or mild global score, severe global score was associated with increased risks of nonrelapse and overall mortality across time but not with a decreased risk of recurrent malignancy. The National Institutes of Health global score predicts mortality risk throughout the course of patients with chronic graft-versus-host disease. Further research is re

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