Journal
BRITISH JOURNAL OF HAEMATOLOGY
Volume 157, Issue 6, Pages 732-741Publisher
WILEY-BLACKWELL
DOI: 10.1111/j.1365-2141.2012.09114.x
Keywords
acute GVHD; risk; grading system; prognosis; haematopoietic cell transplantation
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Funding
- NHLBI NIH HHS [U10 HL069290] Funding Source: Medline
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To define high-risk acute graft-versus-host disease (GVHD) at onset, we examined the initial GVHD stage and grade of 864 patients at the University of Minnesota who received uniform therapy with prednisone 60 similar to mg/m2 similar to per similar to d. We compared the prognostic utility of the Minnesota (MN; modified from Consensus) versus Center for International Blood and Marrow Transplant Research (CIBMTR) GVHD organ stage-derived grading systems. As neither GVHD grading system optimally predicted outcomes, a novel acute GVHD risk score was devised by combining the MN and CIBMTR systems. Using multiple regression analysis, we could dichotomize patients into high risk (HR, n similar to=similar to 86) acute GVHD with initial grade IIIC, IIID or IVD who were less likely to respond to steroid therapy by day 28 [relative risk (RR), 0.3, P similar to
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