Verification of the new grading scale for ocular chronic graft-versus-host disease developed by the German-Austrian-Swiss consensus conference on chronic GVHD
Verification of the new grading scale for ocular chronic graft-versus-host disease developed by the German-Austrian-Swiss consensus conference on chronic GVHD
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DOI：
10.1007/s00277-015-2575-9
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发表时间：
2016-02-01
影响因子：
3.5
通讯作者：
Dietrich-Ntoukas, Tina
中科院分区：
文献类型：
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作者：
Blecha, Christiane;Wolff, Daniel;Dietrich-Ntoukas, Tina
该研究的目的是验证最近提出的慢性移植物抗宿主病(CGVHD)眼部表现的新分级系统。CGVHD的诊断是基于NIH的共识标准。此外，还应用了由德国-奥地利-瑞士关于cGVHD临床实践的共识会议制定的评分表。66例眼部cGVHD患者，男46例，女20例，平均年龄48岁。应用建议的Consensus Conference分级显示，所有轻度(33%)、中度(44%)或重度(23%)炎症的患者都有炎症活动。NIH评分系统的临床评分显示，6%的患者有轻度症状；59%的患者有中度干眼症状，部分影响日常生活能力，没有视力障碍；35%的患者有严重的干眼症状，显著影响日常活动。Consensus Conference分级量表的临床特征和分级显示，眼部cGVHD(1)经常导致基于泪腺功能受损和角膜、结膜和眼睑受累的严重眼表疾病；(2)主要与持续的炎症活动有关；(3)通常导致功能障碍和生活质量下降；(4)与严重的威胁视力的并发症的风险增加有关。
The purpose of the study was to validate a recently proposed new grading system for ocular manifestations of chronic graft-versus-host disease (cGVHD). Diagnosis of cGVHD was based on the NIH consensus criteria. In addition, a grading scale was applied, which has been developed by the German-Austrian-Swiss Consensus Conference on Clinical Practice in cGVHD. Sixty-six patients (male n=46, female n=20, mean age 48 years) with ocular cGVHD were included. Application of the proposed Consensus Conference grading revealed inflammatory activity in all patients with mild (33 %), moderate (44 %), or severe inflammation (23 %). Clinical scoring by the NIH scoring system showed that 6 % of patients had mild symptoms; 59 % of patients had moderate dry eye symptoms partially affecting activities of daily living, without vision impairment; and 35 % of patients had severe dry eye symptoms significantly affecting daily activities. Clinical characterization and grading by the Consensus Conference grading scale revealed that ocular cGVHD (1) frequently leads to severe ocular surface disease based on impaired function of the lacrimal glands and involvement of cornea, conjunctiva, and lids; (2) is mostly associated with ongoing inflammatory activity; (3) often leads to functional impairment and reduced quality of life; and (4) is associated with an increased risk for severe, sight-threatening complications.