Arora et al reported a chronic GVHD risk score for patient's with chronic graft-versus-host disease (GVHD) following bone marrow transplant. The author are from multiple international institutions participating in the Center for International Blood and Marrow Transplant Research.
Patient selection: chronic GVHD following bone marrow transplant
Parameters:
(1) recipient's age at transplantation
(2) history of acute GVHD
(3) number of months between transplant and onset of chronic GVHD
(4) serum total bilirubin at onset of chronic GVHD
(5) Karnofsky Performance Status (KPS) at onset of chronic GVHD
(6) platelet count at onset of chronic GVHD
(7) type of donor
(8) status of underlying disease at the time of transplantation
(9) sex mismatch between donor and recipient
(10) GVHD prophylaxis
|
Parameter |
Finding |
Points |
|
recipient's age |
<= 29 years |
0 |
|
|
30 to 59 years |
1 |
|
|
>= 60 years |
2 |
|
history of acute GVHD |
no |
0 |
|
|
yes |
1 |
|
interval in months |
< 5 months |
1 |
|
|
>= 5 months |
0 |
|
total serum biliruin at onset |
<= 2 mg/dL |
0 |
|
|
> 2 mg/dL |
2 |
|
KPS at onset |
>= 80 percent |
0 |
|
|
10 to 80 |
1 |
|
platelet count at onset |
>= 100,000 per µL |
0 |
|
|
< 100,000 per µL |
1 |
|
type of donor |
HLA-identical sibling |
0 |
|
|
well-matched or partially matched unrelated donor |
0 |
|
|
other related |
1 |
|
|
unmatched unrelated donor |
1 |
|
disease status |
early |
0 |
|
|
intermediate |
1 |
|
|
advanced |
2 |
|
sex mismatch |
female donor, male recipient |
1 |
|
|
other |
0 |
|
GVHD prophylaxis |
cyclosporine plus methotrexate plus other |
0 |
|
|
tacrolimus plus methotrexate plus other |
1 |
|
|
tracrolimus plus methotrexate plus T-cell depletion |
1 |
total score =
= SUM(points for all 10 paramters)
Interpretation:
• minimum score: 0
• maximum score: 13
• The higher the score the worse the overall survival.
|
Total Score |
5-Year Survival |
|
0 to 2 |
91% |
|
3 to 6 |
67% |
|
7 or 8 |
51% |
|
9 or 10 |
40% |
|
11 |
21% |
|
12 or 13 |
4% |
Purpose: To evaluate a patient with chronic graft-versus-host disease (GVHD) using the score of Arora et al.
Specialty: Immunology/Rheumatology
Objective: risk factors, severity, prognosis, stage, response to therapy
ICD-10: T86.0,
