Description

Jacobsohn et al used a score to monitor patients with chronic graft-versus-host disease (GVHD). This can be used to determine a patient's response to therapy of time. The authors are from Children's Memorial Hospital Chicago, the Johns Hopkins University and William Beaumont Hospital at Royal Oak, Michigan.


 

Patient selection: chronic GVHD

 

Assessment interval: every 3 months

 

Parameters:

(1) lichenoid/erythematous lesions in skin

(2) scleroderma-like changes in skin

(3) fascial changes

(4) mouth symptoms

(5) oral examination

(6) total serum bilirubin (as indicator of hepatic injury)

(7) worsening in any other domain

 

Data generated:

(1) previous total score for the first 6 items

(2) current total score for the first 6 items

(3) delta score for each of the first 6 items

 

delta score for a domain =

= (previous score) - (current score)

 

Remission (not defined in paper):

(1) previous total score > 0

(2) current total score = 0

(3) no delta score negative (none show worsening)

 

Major response:

(1) at least one delta score (of the first 6 items) >= 2

(2) no delta score negative (none show worsening)

 

Minor response:

(1) at least one delta score (of the first 6 items) = 1

(2) no delta score negative (none show worsening)

 

Progression:

(1) at least one delta score negative (worsening)

 

Unchanged (not defined in paper):

(1) no change between the 2 assessments

 


To read more or access our algorithms and calculators, please log in or register.