Prognostic Implications of the NIH Consensus Criteria in Children with Chronic Graft-versus-Host Disease
Yonsei Medical Journal
;
: 779-786, 2011.
Article
in English
| WPRIM
| ID: wpr-155383
ABSTRACT
PURPOSE:
In this study, we analyzed a cohort of children with chronic graft-versus-host disease (GvHD) according to the NIH consensus classification (NCC) in order to observe whether global assessment at diagnosis correlates with GvHD-specific endpoints. We then studied the clinical course of these patients, specifically with regards to episodes of GvHD exacerbation requiring treatment escalation. MATERIALS ANDMETHODS:
Recipients of either allogeneic bone marrow transplantation (BMT) or peripheral blood stem cell transplantation (PBSCT) from January 2006 to August 2008 at the Department of Pediatrics, The Catholic University of Korea were evaluated for chronic GvHD, which was diagnosed according to the NCC. The course of chronic GvHD in these patients was then followed.RESULTS:
Of 59 evaluable patients, 23 developed chronic GvHD for a cumulative incidence of 39.3%. Upon multivariate analysis, previous acute GvHD (> or =grade II) had a significant impact on chronic GvHD incidence. With a median duration of systemic treatment for chronic GvHD of 501 days, no significant relationship was found between initial global severity of chronic GvHD and either duration of immunosuppressive treatment or final clinical response to treatment. Fifteen patients (65%) experienced at least one episode of chronic GvHD exacerbation during the period of follow-up, with a median of four exacerbations in the subgroup of patients who experienced such events. Lung GvHD resulted in the highest number of exacerbations per diagnosed patient, followed by oral GvHD.CONCLUSION:
Analysis of this small cohort indicates that global assessment as proposed by the NCC may have limited correlations with GvHD-specific endpoints, possibly due to the favorable response of children to treatment.
Full text:
Available
Index:
WPRIM (Western Pacific)
Main subject:
Prognosis
/
United States
/
Consensus Development Conferences, NIH as Topic
/
Chronic Disease
/
Risk Factors
/
Cohort Studies
/
Bone Marrow Transplantation
/
Peripheral Blood Stem Cell Transplantation
/
Republic of Korea
/
Graft vs Host Disease
Type of study:
Etiology study
/
Incidence study
/
Observational study
/
Prognostic study
/
Risk factors
Limits:
Adolescent
/
Child
/
Child, preschool
/
Female
/
Humans
/
Infant
/
Male
Country/Region as subject:
North America
/
Asia
Language:
English
Journal:
Yonsei Medical Journal
Year:
2011
Type:
Article
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