Center for international blood and marrow transplant research chronic graft-versus-host disease risk score predicts mortality in an independent validation cohort

Mukta Arora, Michael T. Hemmer, Kwang Woo Ahn, John P. Klein, Corey S. Cutler, Alvaro Urbano-Ispizua, Daniel R. Couriel, Amin M. Alousi, Robert Peter Gale, Yoshihiro Inamoto, Daniel J. Weisdorf, Peigang Li, Joseph H. Antin, Brian J. Bolwell, Michael Boyiadzis, Jean Yves Cahn, Mitchell S. Cairo, Luis M. Isola, David A. Jacobsohn, Madan JagasiaThomas R. Klumpp, Effie W. Petersdorf, Stella Santarone, Harry C. Schouten, John R. Wingard, Stephen R. Spellman, Steven Z. Pavletic, Stephanie J. Lee, Mary M. Horowitz, Mary E D Flowers

Research output: Contribution to journalArticlepeer-review

17 Scopus citations

Abstract

We previously reported a risk score that predicted mortality in patients with chronic graft-versus-host disease (CGVHD) after hematopoietic stem cell transplantation (HCT) between 1995 and 2004 and reported to the Center for International Blood and Marrow Transplant Research (CIBMTR). We sought to validate this risk score in an independent CIBMTR cohort of 1128 patients with CGVHD who underwent transplantation between 2005 and 2007 using the same inclusion criteria and risk score calculations. According to the sum of the overall risk score (range, 1 to 12), patients were assigned to 4 risk groups (RGs): RG1 (0 to 2), RG2 (3 to 6), RG3 (7 to 8), and RG4 (9 to 10). RG3 and RG4 were combined, as RG4 accounted for only 1% of the total cohort. Cumulative incidences of nonrelapse mortality (NRM) and probability of overall survival were significantly different between each RG (all P < .01). NRM and overall survival at 5 years after CGVHD for each RG were 17% and 72% in RG1, 26% and 53% in RG2, and 44% and 25% in RG3, respectively (all. P< .01). Our study validates the prognostic value of the CIBMTR CGVHD RGs for overall survival and NRM in a contemporary transplantation population. The CIBMTR CGVHD RGs can be used to predict major outcomes, tailor treatment planning, and enroll patients in clinical trials.

Original languageEnglish (US)
Pages (from-to)640-645
Number of pages6
JournalBiology of Blood and Marrow Transplantation
Volume21
Issue number4
DOIs
StatePublished - Apr 1 2015

Bibliographical note

Funding Information:
The CIBMTR is supported by Public Health Service Grant/Cooperative Agreement U24-CA076518 from the National Cancer Institute (NCI), the National Heart, Lung, and Blood Institute (NHLBI) and the National Institute of Allergy and Infectious Diseases (NIAID); a grant/cooperative agreement 5U10HL069294 from NHLBI and NCI ; a contract HHSH250201200016C with Health Resources and Services Administration (HRSA/DHHS); 2 grants N00014-13-1-0039 and N00014-14-1-0028 from the Office of Naval Research ; and grants from ∗ Actinium Pharmaceuticals ; Allos Therapeutics , Inc.; ∗ Amgen , Inc.; anonymous donation to the Medical College of Wisconsin; Ariad; Be the Match Foundation; ∗ Blue Cross and Blue Shield Association; ∗ Celgene Corporation; Chimerix, Inc.; Fred Hutchinson Cancer Research Center; Fresenius-Biotech North America, Inc.; ∗ Gamida Cell Teva Joint Venture Ltd.; Genentech, Inc.; ∗ Gentium SpA; Genzyme Corporation; GlaxoSmithKline; Health Research, Inc. Roswell Park Cancer Institute; HistoGenetics, Inc.; Incyte Corporation; Jeff Gordon Children's Foundation; Kiadis Pharma; The Leukemia & Lymphoma Society; Medac GmbH; The Medical College of Wisconsin; Merck & Co, Inc.; Millennium: The Takeda Oncology Co.; ∗ Milliman USA, Inc.; ∗ Miltenyi Biotec, Inc.; National Marrow Donor Program; Onyx Pharmaceuticals; Optum Healthcare Solutions, Inc.; Osiris Therapeutics, Inc.; Otsuka America Pharmaceutical, Inc.; Perkin Elmer, Inc.; ∗ Remedy Informatics; ∗ Sanofi US; Seattle Genetics; Sigma-Tau Pharmaceuticals; Soligenix, Inc.; St. Baldrick's Foundation; StemCyte, A Global Cord Blood Therapeutics Co.; Stemsoft Software, Inc.; Swedish Orphan Biovitrum; ∗ Tarix Pharmaceuticals; ∗ TerumoBCT; ∗ Teva Neuroscience, Inc.; ∗ THERAKOS, Inc.; University of Minnesota; University of Utah; and ∗ Wellpoint, Inc. The views expressed in this article do not reflect the official policy or position of the National Institute of Health, the Department of the Navy, the Department of Defense, Health Resources and Services Administration, or any other agency of the US Government.

Keywords

  • Chronic graft-versus-host disease (CGVHD)
  • Nonrelapse mortality
  • Risk score

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