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Predictors of death from chronic graft-versus-host disease after bone marrow transplantation
| Content Provider | Scilit |
|---|---|
| Author | Wingard, Jr Piantadosi, S. Vogelsang, Gb Farmer, Er Jabs, Da Levin, Ls Beschorner, We Cahill, Ra Miller, Df Harrison, D. |
| Copyright Year | 1989 |
| Description | Chronic graft-v-host disease (chronic GVHD) is a frequent cause of late morbidity and death after bone marrow transplantation (BMT). The actuarial survival after onset of chronic GVHD in 85 patients was 42% (95%Cl = 29%, 54%) at 10 years. Baseline characteristics present at the onset of chronic GVHD (before therapy) in 85 patients were reviewed to determine which were risk factors for death. In a multivariate proportional hazards analysis, three baseline factors emerged as independent predictors of death: progressive presentation (chronic GVHD following acute GVHD without resolution of acute GVHD; hazard ratio of 4.1, 95% Cl = 2.1 to 7.8), lichenoid changes on skin histology (hazard ratio of 2.2, 95% Cl = 1.1 to 4.3), and elevation of serum bilirubin greater than 1.2 mg/dL (hazard ratio = 2.1, 95% Cl = 1.1 to 4.1). Actuarial survival of 23 chronic GVHD patients with none of these risk factors was 70% at 6 years (95% Cl = 38%, 88%). Thirty-eight patients with one of these risk factors had a projected 6-year survival of 43% (95% Cl = 21%, 63%). The 29 patients with any combination of two or more of these factors had a projected 6-year survival of only 20% (95% Cl = 8%, 37%). Identification of baseline risk factors should facilitate design of trials of chronic GVHD therapies and assignment of high-risk patients to more aggressive innovative therapeutic regimens. |
| Related Links | https://ashpublications.org/blood/article-pdf/74/4/1428/216517/1428.pdf |
| Ending Page | 1435 |
| Page Count | 8 |
| Starting Page | 1428 |
| DOI | 10.1182/blood.v74.4.1428.bloodjournal7441428 |
| Journal | Blood |
| Issue Number | 4 |
| Volume Number | 74 |
| Language | English |
| Publisher | American Society of Hematology |
| Publisher Date | 1989-09-01 |
| Access Restriction | Open |
| Subject Keyword | Hematology Survival Graft Bone Marrow Death Transplantation Baseline Actuarial Chronic Gvhd Journal: Blood (Vol- 76, Issue- 4) |
| Content Type | Text |
| Resource Type | Article |
