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Impact of the 2014 NIH chronic graft-versus-host disease scoring criteria modifications assessed in a large cohort of severely affected patients

Bone Marrow Transplantation volume 54, pages 76–84 (2019)Cite this article

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Abstract

In 2005, the National Institutes of Health (NIH) chronic graft-versus-host disease (cGVHD) consensus project provided diagnosis and staging criteria, based mostly on clinical experience and expert opinion. These criteria were revised in 2014, aiming to provide enhanced specificity and clarity. However, the impact of 2014 changes to the original NIH cGVHD severity scoring criteria has not been reported. In this study, 284 patients, prospectively enrolled on the National Cancer Institute's cross-sectional cGVHD natural history study, were scored using the 2005 NIH cGVHD criteria and then rescored according to the 2014 modifications. In comparing the two criteria, 2014 cGVHD global severity scoring resulted in a tendency toward being categorized as milder scores (75 vs. 72% of severe score per 2014, p = 0.0009), with a statistically significant shift in NIH liver and lung scores toward milder categories (p < 0.0001). 2005 and 2014 NIH global severity scores showed a significant association with reduced grip strength (p < 0.0001), reduced joint range of motion (p = 0.0003), and the subspecialist evaluation score (p < 0.0001). Poor survival prediction of the severe NIH lung score is also retained in the new criteria (p = 0.0012). These findings support the use of 2014 cGVHD scoring criteria in continuous efforts to develop better classification systems.

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Authors and Affiliations

  1. Experimental Transplantation and Immunology Branch, Center for Cancer Research (CCR), National Cancer Institute (NCI), National Institutes of Health (NIH), Bethesda, MD, USA

    Ana Zelic Kerep, Jacob Broome, Filip Pirsl, Lauren M. Curtis, Megan Kenyon, Judy Baruffaldi, Daniel H. Fowler, Ronald E. Gress & Steven Z. Pavletic

  2. Division of Hematology, Department of Internal Medicine, University Hospital Center Zagreb, Zagreb, Croatia

    Ana Zelic Kerep & Drazen Pulanic

  3. Biostatistics and Data Management Section, National Cancer Institute, Center for Cancer Research, National Institutes of Health, Bethesda, MD, USA

    Seth M. Steinberg

  4. Outcomes Research Branch, Division of Cancer Control and Population Sciences, CCR, NCI, NIH, Rockville, MD, USA

    Sandra A. Mitchell

  5. Dermatology Branch, National Institute of Arthritis and Musculoskeletal and Skin Diseases, NIH, Bethesda, MD, USA

    Edward W. Cowen & Dominique C. Pichard

  6. Rehabilitation Medicine Department, Clinical Center, NIH, Bethesda, MD, USA

    Galen O. Joe & Leora E. Comis

  7. National Institute of Dental and Craniofacial Research, NIH, Bethesda, MD, USA

    Jacqueline W. Mays

  8. National Eye Institute, NIH, Bethesda, MD, USA

    Manuel B. Datiles III

  9. Eunice Kennedy Shriver National Institute of Child Health and Human Development, NIH, Bethesda, MD, USA

    Pamela Stratton & Jessica Zolton

  10. Department of Pain and Palliative Care, Clinical Center, NIH, Bethesda, MD, USA

    Ann Berger

  11. Social Work Department, Clinical Center, National Institutes of Health, Bethesda, MD, USA

    Jennifer Hendricks

  12. Office of the Clinical Director, Center for Cancer Research, NCI, NIH, Bethesda, MD, USA

    Irina Titarenko

  13. University of Zagreb School of Medicine, Zagreb, Croatia

    Drazen Pulanic

  14. Faculty of Medicine Osijek, J.J. Strossmayer University of Osijek, Osijek, Croatia

    Drazen Pulanic

  15. Pediatric Oncology Branch, CCR, NCI, NIH, Bethesda, MD, USA

    Kristin Baird

Authors
  1. Ana Zelic Kerep
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  2. Jacob Broome
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Correspondence to Ana Zelic Kerep.

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Kerep, A.Z., Broome, J., Pirsl, F. et al. Impact of the 2014 NIH chronic graft-versus-host disease scoring criteria modifications assessed in a large cohort of severely affected patients. Bone Marrow Transplant 54, 76–84 (2019). https://doi.org/10.1038/s41409-018-0224-3

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