Center for International Blood and Marrow Transplant Research Chronic Graft-versus-Host Disease Risk Score Predicts Mortality in an Independent Validation Cohort

• Published in: Biology of blood and marrow transplantation 2015-04, Vol.21 (4), p.640-645
• Main Authors: Arora, Mukta, Hemmer, Michael T, Ahn, Kwang Woo, Klein, John P, Cutler, Corey S, Urbano-Ispizua, Alvaro, Couriel, Daniel R, Alousi, Amin M, Gale, Robert Peter, Inamoto, Yoshihiro, Weisdorf, Daniel J, Li, Peigang, Antin, Joseph H, Bolwell, Brian J, Boyiadzis, Michael, Cahn, Jean-Yves, Cairo, Mitchell S, Isola, Luis M, Jacobsohn, David A, Jagasia, Madan, Klumpp, Thomas R, Petersdorf, Effie W, Santarone, Stella, Schouten, Harry C, Wingard, John R, Spellman, Stephen R, Pavletic, Steven Z, Lee, Stephanie J, Horowitz, Mary M, Flowers, Mary E.D
• Format: Article
• Language: English
• Subjects: Adult; Aged; Allografts; Chronic Disease; Chronic graft-versus-host disease (CGVHD); Cohort Studies; Disease-Free Survival; Female; Follow-Up Studies; Graft vs Host Disease - mortality; Hematology, Oncology and Palliative Medicine; Hematopoietic Stem Cell Transplantation; Humans; Incidence; Male; Middle Aged; Nonrelapse mortality; Retrospective Studies; Risk Factors; Risk score; Survival Rate
• ISSN: 1083-8791; 1523-6536
• DOI: 10.1016/j.bbmt.2014.10.022

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.