Abstract
To assess the applicability of the National Institutes of Health (NIH) consensus criteria (NCC) for chronic graft-versus-host disease (cGVHD), 211 patients who developed GVHD more than 100 days after allogeneic transplantation were reclassified using NCC. Classifications were: late acute GVHD (44 patients, 21%), overlap syndrome (64 patients, 30%) and classic cGVHD (103 patients, 49%). Classic cGVHD and overlap syndrome patients (n=167) were graded using both the revised Seattle criteria (RSC) and NIH global scoring (NGS). Twenty-three patients (14%) had mild, 81 (48%) had moderate and 63 (38%) had severe cGVHD. After a median follow-up of 46 months (range 5–71 months), the 4-year GVHD-specific survival was not significantly different among the different subtypes of NCC. Among patients with late acute GVHD, however, the pattern of acute GVHD onset (late, persistent or recurrent) was significantly different with respect to GVHD-specific survival. Among patients with overlap syndrome and classic cGVHD, multivariate analysis showed that NGS as well as RSC were useful in predicting survival and discontinuation of immunosuppressive therapy despite of more detailed grouping. Our study indicates that NCC is applicable. The clinical impact of NIH types and NGS should be verified through prospective studies.
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Acknowledgements
The statistical analyses performed in this article were advised by Catholic Medical Center Clinical Research Coordinating Center. We especially thank to Hyeon-Woo, Yim, MD, PhD and Seung-Hee, Jeong, MPH.
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Cho, BS., Min, CK., Eom, KS. et al. Feasibility of NIH consensus criteria for chronic graft-versus-host disease. Leukemia 23, 78–84 (2009). https://doi.org/10.1038/leu.2008.276
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DOI: https://doi.org/10.1038/leu.2008.276
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