Association of severity of organ involvement with mortality and recurrent malignancy in patients with chronic graft-versus-host disease

Yoshihiro Inamoto, Paul J. Martin, Barry E. Storer, Jeanne Palmer, Daniel J. Weisdorf, Joseph Pidala, Mary E.D. Flowers, Mukta Arora, Madan Jagasia, Sally Arai, Xiaoyu Chai, Steven Z. Pavletic, Georgia B. Vogelsang, Stephanie J. Lee

Research output: Contribution to journalArticle

15 Citations (Scopus)

Abstract

The National Institutes of Health global score for chronic graft-versus-host disease was devised by experts but was not based on empirical data. We hypothesized that analysis of prospectively collected data would enable derivation of a more accurate model for estimating mortality risk. We analyzed 574 adult patients with chronic graft-versus- host disease enrolled in a multicenter, observational study, using multivariate time-varying analysis accounting for serial changes in severity of involvement of eight individual organ sites over time. In the training set, severity of skin, mouth, gastrointestinal tract, liver and lung involvement were independently associated with the risk of non-relapse mortality. Weighted mortality points were assigned to individual organs based on the hazard ratios and were summed. The population was divided into three risk groups based on the total mortality points. The three new risk groups were validated in an independent validation set, but did not show better discriminative performance than the National Institutes of Health global score. As compared to a moderate or mild global score, a severe global score was associated with increased risks of non-relapse and overall mortality across time but not with a decreased risk of recurrent malignancy. The National Institutes of Health global score predicts patients’ mortality risk throughout the course of their chronic graft-versus-host disease. Further research is required in order to improve outcomes in patients with severe chronic graft-versus-host disease, since their risk of mortality remains elevated.

Original languageEnglish (US)
Pages (from-to)1618-1623
Number of pages6
JournalHaematologica
Volume99
Issue number10
DOIs
StatePublished - Jan 1 2014

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Graft vs Host Disease
Mortality
Neoplasms
National Institutes of Health (U.S.)
Multicenter Studies
Observational Studies
Mouth
Gastrointestinal Tract
Lung
Skin
Liver
Research
Population

ASJC Scopus subject areas

  • Hematology

Cite this

Association of severity of organ involvement with mortality and recurrent malignancy in patients with chronic graft-versus-host disease. / Inamoto, Yoshihiro; Martin, Paul J.; Storer, Barry E.; Palmer, Jeanne; Weisdorf, Daniel J.; Pidala, Joseph; Flowers, Mary E.D.; Arora, Mukta; Jagasia, Madan; Arai, Sally; Chai, Xiaoyu; Pavletic, Steven Z.; Vogelsang, Georgia B.; Lee, Stephanie J.

In: Haematologica, Vol. 99, No. 10, 01.01.2014, p. 1618-1623.

Research output: Contribution to journalArticle

Inamoto, Y, Martin, PJ, Storer, BE, Palmer, J, Weisdorf, DJ, Pidala, J, Flowers, MED, Arora, M, Jagasia, M, Arai, S, Chai, X, Pavletic, SZ, Vogelsang, GB & Lee, SJ 2014, 'Association of severity of organ involvement with mortality and recurrent malignancy in patients with chronic graft-versus-host disease', Haematologica, vol. 99, no. 10, pp. 1618-1623. https://doi.org/10.3324/haematol.2014.109611
Inamoto, Yoshihiro ; Martin, Paul J. ; Storer, Barry E. ; Palmer, Jeanne ; Weisdorf, Daniel J. ; Pidala, Joseph ; Flowers, Mary E.D. ; Arora, Mukta ; Jagasia, Madan ; Arai, Sally ; Chai, Xiaoyu ; Pavletic, Steven Z. ; Vogelsang, Georgia B. ; Lee, Stephanie J. / Association of severity of organ involvement with mortality and recurrent malignancy in patients with chronic graft-versus-host disease. In: Haematologica. 2014 ; Vol. 99, No. 10. pp. 1618-1623.
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