TY - JOUR
T1 - Predictors of survival, Nonrelapse mortality, And failure-Free survival in patients treated for chronic graft-Versus-Host disease
AU - Palmer, Jeanne
AU - Chai, Xiaoyu
AU - Pidala, Joseph
AU - Inamoto, Yoshihiro
AU - Martin, Paul J.
AU - Storer, Barry
AU - Pusic, Iskra
AU - Flowers, Mary E D
AU - Arora, Mukta
AU - Pavletic, Steven Z.
AU - Lee, Stephanie J.
N1 - Publisher Copyright:
© 2016 by The American Society of Hematology.
PY - 2016/1/7
Y1 - 2016/1/7
N2 - Chronic graft-versus-host disease (GVHD) is a pleotropic syndrome that lacks validated methods of measuring response in clinical trials, although several end points have been proposed. To investigate the prognostic significance of these proposed end points, such as the 2005 National Institutes of Health (NIH) response measures, 2014 NIH response measures, clinician-reported response, and patient-reported response, we tested their ability to predict subsequent overall survival (OS), nonrelapse mortality (NRM), and failure-free survival (FFS). Patients (n 5 575) were enrolled on a prospective chronic GVHD observational trial. At 6 months, clinician-reported response (P 5 .004) and 2014 NIH-calculated response (P 5 .001) correlated with subsequent FFS, and clinician reported response predicted OS (P 5 .007). Multivariate models were used to identify changes in organ involvement, laboratory values, and patient-reported outcomes that were associated with long-term outcomes. At 6 months, a change in the 2005 NIH 0 to 3 clinician-reported skin score and 0 to 10 patient-reported itching score predicted subsequent FFS. Change in the Lee skin symptom score and Functional Assessment of Cancer Therapy-Bone Marrow Transplant score predicted subsequent OS. Change in the Lee skin symptom score predicted subsequent NRM. This study provides evidence that clinician-reported response and patient-reported outcomes are predictive of long-term survival.
AB - Chronic graft-versus-host disease (GVHD) is a pleotropic syndrome that lacks validated methods of measuring response in clinical trials, although several end points have been proposed. To investigate the prognostic significance of these proposed end points, such as the 2005 National Institutes of Health (NIH) response measures, 2014 NIH response measures, clinician-reported response, and patient-reported response, we tested their ability to predict subsequent overall survival (OS), nonrelapse mortality (NRM), and failure-free survival (FFS). Patients (n 5 575) were enrolled on a prospective chronic GVHD observational trial. At 6 months, clinician-reported response (P 5 .004) and 2014 NIH-calculated response (P 5 .001) correlated with subsequent FFS, and clinician reported response predicted OS (P 5 .007). Multivariate models were used to identify changes in organ involvement, laboratory values, and patient-reported outcomes that were associated with long-term outcomes. At 6 months, a change in the 2005 NIH 0 to 3 clinician-reported skin score and 0 to 10 patient-reported itching score predicted subsequent FFS. Change in the Lee skin symptom score and Functional Assessment of Cancer Therapy-Bone Marrow Transplant score predicted subsequent OS. Change in the Lee skin symptom score predicted subsequent NRM. This study provides evidence that clinician-reported response and patient-reported outcomes are predictive of long-term survival.
KW - And the 2014 NIH response criteria
KW - Changes in patient-reported outcomes
KW - FFS was predicted by clinician-assessed response
KW - Survival of chronic GVHD patients was predicted by clinician-assessed response and changes in patient reported outcomes
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U2 - 10.1182/blood-2015-08-662874
DO - 10.1182/blood-2015-08-662874
M3 - Article
C2 - 26527676
AN - SCOPUS:84955516059
SN - 0006-4971
VL - 127
SP - 160
EP - 166
JO - Blood
JF - Blood
IS - 1
ER -