Filipovich et al developed criteria for the severity of chronic graft-versus-host disease (GVHD) for the National Institutes of Health. One of the criteria involved lung involvement.
Patient selection: chronic GVHD
Parameters:
(1) FEV1 as percent of predicted
(2) DLco as percent of predicted
(3) symptoms
(4) require oxygen
|
Parameter |
Finding |
Points |
|
FEV1 |
> 80% of predicted |
1 |
|
|
70 to 80% |
2 |
|
|
60 to 70% |
3 |
|
|
< 60% |
4 |
|
DLco |
> 80% of predicted |
1 |
|
|
70 to 80% |
2 |
|
|
60 to 70^ |
3 |
|
|
< 60% |
4 |
pretransplant lung function score = pretransplant LFS =
= (points for FEV1) + (points for DLco)
|
Parameter |
Finding |
Grade |
|
symptoms |
None |
0 |
|
|
mild (dyspnea after 1 flight of stairs) |
1 |
|
|
Moderate |
2 |
|
|
severe (dyspnea at rest) |
3 |
|
need for oxygen |
No |
0 |
|
|
Yes |
3 |
|
FEV1 as percent of predicted |
> 80% |
0 |
|
|
60 to 79% |
1 |
|
|
40 to 59% |
2 |
|
|
< 40% |
3 |
|
pretransplant LFS |
2 |
0 |
|
|
3 to 4 |
1 |
|
|
5 or 6 |
2 |
|
|
7 or 8 |
3 |
where:
• A footnote says that the pretransplant score range is 2 to 12. It actually ranges from 2 to 8.
grade for lung involvement =
= MAX(grades)
Specialty: Immunology/Rheumatology
