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Prognostic Factor Score of Akpek et al for a Patient with Chronic Graft-versus-Host Disease (GVHD)

Purpose: To evaluate a patient with chronic graft-versus-host disease (GVHD) using the prognostic factor score of Akpek et al.

Description

Akpek et al developed a prognostic factor score (PS) for a patient with chronic graft-versus-host disease (GVHD). This can help identify a patient who may benefit from more aggressive management. The authors are from Johns Hopkins University, Fred Hutchinson Cancer Center in Seattle, University of Nebraska, University of Minnesota, and the International BMT Registry GVHD Working Group in Milwaukee.


Chronic GVHD occurs months or years after bone marrow transplantation.

 

Parameters:

(1) extent of skin involvement

(2) platelet count

(3) type of onset

 

Parameter

Finding

Points

extent of skin involvement

<= 50% of BSA

0

 

> 50% of BSA

1

platelet count

>= 100,000 per µL

0

 

< 100,000 per µL

1

type of onset

progressive type

1

 

other

0

 

where:

• Progressive type onset = presence of acute and chronic GVHD features on serial biopsies.

 

prognostic factor score =

= (1.949 * (points for skin extent)) + (1.293 * (points for platelet count)) + (0.514 * (points for type of onset))

 

Interpretation:

• minimum score: 0

• maximum score: 3.756

• The higher the score the worse the prognosis is for the patient.

 

Score

Risk Group

Probability of cGVHD Specific Survival at 10 Years (JHU Cohort)

0

low

90%

0.514 - 1.949

intermediate

57%

>= 2

high

6-7%

from Figure 1, page 805


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Specialty

Objective

ICD-10