Lee et al used clinical findings to classify the severity of chronic graft-versus-host disease (GVHD). The authors are from multiple institutions from around the world participating in the International Bone Marrow Transplant Registry.
Patient selection: chronic GVHD
Parameters:
(1) Karnofsky performance status (KPS)
(2) chronic diarrhea (CD)
(3) weight loss (WL)
(4) skin involvement (SI)
(5) oral involvement (OI)
subscore 1 =
= (1 if CD present, else 0) + (1 if WL present, else 0)
subscore 2 =
= (1 if CD present, else 0) + (1 if WL present, else 0) + (1 if SI present, else 0)
|
KPA |
Subscore 1 |
Subscore 2 |
OI |
Severity |
|
>= 80% |
0 |
NA |
NA |
low |
|
>= 80% |
1 |
NA |
NA |
intermediate |
|
>= 80% |
2 |
NA |
NA |
high |
|
< 80% |
NA |
0 |
NA |
intermediate |
|
< 80% |
NA |
1 or 2 |
Y |
intermediate |
|
< 80% |
NA |
1 or 2 |
N |
high |
|
< 80% |
NA |
3 |
NA |
high |
where:
• The scoring with oral involvement is counter-intuitive.
Purpose: To evaluate a patient with chronic graft-versus-host disease (GVHD) using the score of Lee et al.
Specialty: Immunology/Rheumatology
Objective: criteria for diagnosis, severity, prognosis, stage
ICD-10: T86.0,
