Predictors of survival, Nonrelapse mortality, And failure-Free survival in patients treated for chronic graft-Versus-Host disease

Jeanne Palmer, Xiaoyu Chai, Joseph Pidala, Yoshihiro Inamoto, Paul J. Martin, Barry Storer, Iskra Pusic, Mary E.D. Flowers, Mukta Arora, Steven Z. Pavletic, Stephanie J. Lee

Research output: Contribution to journalArticle

19 Citations (Scopus)

Abstract

Chronic graft-versus-host disease (GVHD) is a pleotropic syndrome that lacks validated methods of measuring response in clinical trials, although several end points have been proposed. To investigate the prognostic significance of these proposed end points, such as the 2005 National Institutes of Health (NIH) response measures, 2014 NIH response measures, clinician-reported response, and patient-reported response, we tested their ability to predict subsequent overall survival (OS), nonrelapse mortality (NRM), and failure-free survival (FFS). Patients (n 5 575) were enrolled on a prospective chronic GVHD observational trial. At 6 months, clinician-reported response (P 5 .004) and 2014 NIH-calculated response (P 5 .001) correlated with subsequent FFS, and clinician reported response predicted OS (P 5 .007). Multivariate models were used to identify changes in organ involvement, laboratory values, and patient-reported outcomes that were associated with long-term outcomes. At 6 months, a change in the 2005 NIH 0 to 3 clinician-reported skin score and 0 to 10 patient-reported itching score predicted subsequent FFS. Change in the Lee skin symptom score and Functional Assessment of Cancer Therapy-Bone Marrow Transplant score predicted subsequent OS. Change in the Lee skin symptom score predicted subsequent NRM. This study provides evidence that clinician-reported response and patient-reported outcomes are predictive of long-term survival.

Original languageEnglish (US)
Pages (from-to)160-166
Number of pages7
JournalBlood
Volume127
Issue number1
DOIs
StatePublished - Jan 7 2016

Fingerprint

Graft vs Host Disease
Grafts
Health
National Institutes of Health (U.S.)
Skin
Survival
Mortality
Functional assessment
Transplants
Bone
Bone Neoplasms
Pruritus
Bone Marrow
Clinical Trials

Keywords

  • And the 2014 NIH response criteria
  • Changes in patient-reported outcomes
  • FFS was predicted by clinician-assessed response
  • Survival of chronic GVHD patients was predicted by clinician-assessed response and changes in patient reported outcomes

ASJC Scopus subject areas

  • Biochemistry
  • Immunology
  • Hematology
  • Cell Biology

Cite this

Predictors of survival, Nonrelapse mortality, And failure-Free survival in patients treated for chronic graft-Versus-Host disease. / Palmer, Jeanne; Chai, Xiaoyu; Pidala, Joseph; Inamoto, Yoshihiro; Martin, Paul J.; Storer, Barry; Pusic, Iskra; Flowers, Mary E.D.; Arora, Mukta; Pavletic, Steven Z.; Lee, Stephanie J.

In: Blood, Vol. 127, No. 1, 07.01.2016, p. 160-166.

Research output: Contribution to journalArticle

Palmer, J, Chai, X, Pidala, J, Inamoto, Y, Martin, PJ, Storer, B, Pusic, I, Flowers, MED, Arora, M, Pavletic, SZ & Lee, SJ 2016, 'Predictors of survival, Nonrelapse mortality, And failure-Free survival in patients treated for chronic graft-Versus-Host disease', Blood, vol. 127, no. 1, pp. 160-166. https://doi.org/10.1182/blood-2015-08-662874
Palmer, Jeanne ; Chai, Xiaoyu ; Pidala, Joseph ; Inamoto, Yoshihiro ; Martin, Paul J. ; Storer, Barry ; Pusic, Iskra ; Flowers, Mary E.D. ; Arora, Mukta ; Pavletic, Steven Z. ; Lee, Stephanie J. / Predictors of survival, Nonrelapse mortality, And failure-Free survival in patients treated for chronic graft-Versus-Host disease. In: Blood. 2016 ; Vol. 127, No. 1. pp. 160-166.
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