Global and organ-specific chronic graft-versus-host disease severity according to the 2005 NIH Consensus Criteria
Global and organ-specific chronic graft-versus-host disease severity according to the 2005 NIH Consensus Criteria
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DOI：
10.1182/blood-2011-03-344390
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发表时间：
2011-10-13
期刊：
影响因子：
20.3
通讯作者：
Lee, Stephanie J.
中科院分区：
文献类型：
--
作者：
Arai, Sally;Jagasia, Madan;Lee, Stephanie J.
2005年，美国国立卫生研究院慢性移植物抗宿主病临床试验标准共识发展项目提出了一种针对单个器官的新评分系统以及一种计算整体严重程度（轻度、中度、重度）的算法。慢性移植物抗宿主病联盟成立以测试这些新标准。本报告涵盖了该联盟5个中心招募的首批298名成年患者。使用共识会议推荐的标准化表格，每3 - 6个月对患者进行一次评估。在研究入组时，整体慢性移植物抗宿主病严重程度为轻度的占10%（n = 32），中度的占59%（n = 175），重度的占31%（n = 91）。在大多数病例中，皮肤、肺或眼睛的评分决定了整体严重程度评分，其他5个器官决定了16%的整体严重程度评分。预测慢性移植物抗宿主病发病以及慢性移植物抗宿主病患者非复发死亡率的常规风险因素与美国国立卫生研究院的整体严重程度评分无关。入组时的整体严重程度评分与非复发死亡率（P <.0001）和生存率（P <.0001）相关；2年总生存率为62%（重度）、86%（中度）和97%（轻度）。轻度慢性移植物抗宿主病患者预后良好，而重度慢性移植物抗宿主病患者预后较差。本研究在www.clinicaltrials.gov注册，编号为NCT00637689。（《血液》2011年；118(15):4242 - 4249）
In 2005, the National Institutes of Health Consensus Development Project on Criteria for Clinical Trials in Chronic 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 5 organs determining 16% of the global severity scores. Conventional risk factors predictive for onset of chronic GVHD and nonrelapse mortality in people with chronic GVHD were not associated with NIH global severity scores. Global severity scores at enrollment were associated with nonrelapse mortality (P < .0001) and survival (P < .0001); 2-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 no. NCT00637689. (Blood. 2011;118(15):4242-4249)