{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T10:25:19Z","timestamp":1790418319297,"version":"4.1.0"},"reference-count":30,"publisher":"American Society of Hematology","issue":"5","content-domain":{"domain":["ashpublications.org"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2001,3,1]]},"abstract":"<jats:p>The disease-specific survival (DSS) of 151 patients with chronic graft-versus-host disease (cGVHD) was studied in an attempt to stratify patients into risk groups and to form a basis for a new grading of cGVHD. The data included the outcome and 23 variables at the diagnosis of cGVHD and at the primary treatment failure (PTF). Eighty-nine patients (58%) failed primary therapy for cGVHD. Nonrelapse mortality was 44% after a median follow-up of 7.8 years. The probability of DSS at 10 years after diagnosis of cGVHD (DSS1) and after PTF (DSS2) was 51% (95% confidence interval [CI]\u2009=\u200939%, 60%) and 38% (95% CI\u2009=\u200928%, 49%), respectively. According to multivariate analysis, extensive skin involvement (ESI) more than 50% of body surface area; hazard ratio (HR) of 7.0 (95% CI\u2009=\u20093.6-13.4), thrombocytopenia (TP) (&amp;lt; 100\u2009000\/\u03bcL; HR, 3.6; 95% CI\u2009=\u20091.9-6.8), and progressive-type onset (PTO) (HR, 1.7; 95% CI\u2009=\u20090.9-3.0) significantly influenced DSS1. These 3 factors and Karnofsky Performance Score of less than 50% at PTF were significant predictors for DSS2. The DSS1 at 10 years for patients with prognostic factor score (PFS) at diagnosis of 0 (none), less than 2 (ESI only or TP and\/or PTO), 2 to 3.5 (ESI plus either TP or PTO), and more than 3.5 (all 3 factors) was 82%, 68%, 34%, and 3% (P\u2009=\u2009.05, &amp;lt; .001, &amp;lt; .001), respectively. The DSS2 at 5 years for patients with PFS at PTF of 0, 2 or less, 2 to 3.5, and more than 3.5 were 91%, 71%, 22%, and 4% (P\u2009=\u2009.2, .005, and &amp;lt; .001), respectively. It was concluded that these prognostic models might be useful in grouping the patients with similar outcome.<\/jats:p>","DOI":"10.1182\/blood.v97.5.1219","type":"journal-article","created":{"date-parts":[[2002,7,27]],"date-time":"2002-07-27T12:46:47Z","timestamp":1027774007000},"page":"1219-1226","update-policy":"https:\/\/doi.org\/10.1182\/blood.2019cm0000","source":"Crossref","is-referenced-by-count":158,"title":["Development of a prognostic model for grading chronic graft-versus-host disease"],"prefix":"10.1182","volume":"97","author":[{"given":"Go\u0308rgu\u0308n","family":"Akpek","sequence":"first","affiliation":[{"name":"From the Johns Hopkins Oncology Center, Division of Hematologic Malignancies\/BMT, and Oncology Biostatistics, Baltimore, MD."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marianna L.","family":"Zahurak","sequence":"additional","affiliation":[{"name":"From the Johns Hopkins Oncology Center, Division of Hematologic Malignancies\/BMT, and Oncology Biostatistics, Baltimore, MD."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steven","family":"Piantadosi","sequence":"additional","affiliation":[{"name":"From the Johns Hopkins Oncology Center, Division of Hematologic Malignancies\/BMT, and Oncology Biostatistics, Baltimore, MD."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffrey","family":"Margolis","sequence":"additional","affiliation":[{"name":"From the Johns Hopkins Oncology Center, Division of Hematologic Malignancies\/BMT, and Oncology Biostatistics, Baltimore, MD."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jon","family":"Doherty","sequence":"additional","affiliation":[{"name":"From the Johns Hopkins Oncology Center, Division of Hematologic Malignancies\/BMT, and Oncology Biostatistics, Baltimore, MD."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert","family":"Davidson","sequence":"additional","affiliation":[{"name":"From the Johns Hopkins Oncology Center, Division of Hematologic Malignancies\/BMT, and Oncology Biostatistics, Baltimore, MD."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Georgia B.","family":"Vogelsang","sequence":"additional","affiliation":[{"name":"From the Johns Hopkins Oncology Center, Division of Hematologic Malignancies\/BMT, and Oncology Biostatistics, Baltimore, MD."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"234","reference":[{"key":"2020021221391000000_B1","doi-asserted-by":"crossref","first-page":"207","DOI":"10.7326\/0003-4819-119-3-199308010-00005","article-title":"Allogeneic bone marrow transplantation for chronic myeloid leukemia using sibling and volunteer unrelated donors: a comparison of complications in the first 2 years.","volume":"119","author":"Marks","year":"1993","journal-title":"Ann Intern Med."},{"key":"2020021221391000000_B2","first-page":"368a","article-title":"A prospective, randomized trial of peripheral blood stem cells (PBS) or marrow (BM) for patients undergoing allogeneic transplantation for hematologic malignancies [abstract].","volume":"94","author":"Bensinger","year":"1999","journal-title":"Blood."},{"key":"2020021221391000000_B3","doi-asserted-by":"crossref","first-page":"537","DOI":"10.1200\/JCO.2000.18.3.537","article-title":"Randomized trial of bone marrow versus lenograstim-primed blood cell allogeneic transplantation in patients with early-stage leukemia: a report from the Societe Francaise de Greffe de Moelle.","volume":"18","author":"Blaise","year":"2000","journal-title":"J Clin Oncol."},{"key":"2020021221391000000_B4","first-page":"2706a","article-title":"A randomized trial of filgrastim (G-CSF) stimulated donor marrow (BM) versus peripheral blood (PBPC) for allogeneic transplantation: increased extensive chronic graft versus host disease following PBPC transplantation [abstract].","volume":"94","author":"Durrant","year":"1999","journal-title":"Blood."},{"key":"2020021221391000000_B5","first-page":"1885a","article-title":"The importance of confirming graft versus host disease (GVHD) diagnosis [abstract].","volume":"92","author":"Montross","year":"1998","journal-title":"Blood."},{"key":"2020021221391000000_B6","doi-asserted-by":"crossref","first-page":"204","DOI":"10.1016\/0002-9343(80)90380-0","article-title":"Chronic graft-versus host syndrome in man. A long-term clinicopathologic study of 20 Seattle patients.","volume":"69","author":"Shulman","year":"1980","journal-title":"Am J Med."},{"key":"2020021221391000000_B7","first-page":"247","article-title":"Consensus among bone marrow transplanters for diagnosis, grading and treatment of chronic graft-versus-host disease.","volume":"4","author":"Atkinson","year":"1989","journal-title":"Bone Marrow Transplant."},{"key":"2020021221391000000_B8","doi-asserted-by":"crossref","first-page":"267","DOI":"10.1182\/blood.V57.2.267.267","article-title":"Chronic graft-versus-host disease in 52 patients; adverse natural course and successful treatment with combination immunosuppression.","volume":"57","author":"Sullivan","year":"1981","journal-title":"Blood."},{"key":"2020021221391000000_B9","doi-asserted-by":"crossref","first-page":"546","DOI":"10.1182\/blood.V72.2.546.546","article-title":"Prednisone and azathioprine compared with prednisone and placebo for treatment of chronic graft-versus-host disease: prognostic influence of prolonged thrombocytopenia after allogeneic marrow transplantation.","volume":"72","author":"Sullivan","year":"1988","journal-title":"Blood."},{"key":"2020021221391000000_B10","first-page":"1a","article-title":"Zahurak ML, Piantadosi S, Vogelsang GB. A prognostic model for chronic graft-versus-host disease (cGVHD) [abstract].","volume-title":"Proceedings of Tandem BMT Meetings (IBMTR\/ABMTR);","author":"Akpek","year":"2000"},{"key":"2020021221391000000_B11","doi-asserted-by":"crossref","first-page":"1428","DOI":"10.1182\/blood.V74.4.1428.1428","article-title":"Predictors of death from chronic graft-versus-host disease after bone marrow transplantation.","volume":"74","author":"Wingard","year":"1989","journal-title":"Blood."},{"key":"2020021221391000000_B12","first-page":"201a","article-title":"Chronic graft-versus-host disease after allogeneic blood stem cell or bone marrow transplantation: factors determining the onset and survival [abstract].","volume":"18","author":"Pavletic","year":"1999","journal-title":"Proc Am Soc Clin Oncol."},{"key":"2020021221391000000_B13","doi-asserted-by":"crossref","first-page":"185","DOI":"10.1111\/j.1365-2141.1984.tb02887.x","article-title":"Bone marrow transplantation: a review of delayed complications.","volume":"57","author":"Deeg","year":"1984","journal-title":"Br J Haematol."},{"key":"2020021221391000000_B14","doi-asserted-by":"crossref","first-page":"2002","DOI":"10.1002\/1097-0142(19840501)53:9<2002::AID-CNCR2820530933>3.0.CO;2-W","article-title":"The Karnofsky Performance Status Scale: an examination of its reliability and validity in a research setting.","volume":"53","author":"Mor","year":"1984","journal-title":"Cancer."},{"key":"2020021221391000000_B15","doi-asserted-by":"crossref","first-page":"580","DOI":"10.1001\/archopht.1983.01040010580010","article-title":"The eye in bone marrow transplantation\u2014I. 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graft-vs.-host disease after marrow transplantation: clinical outcome and effect on subsequent immune recovery.","volume":"2","author":"Sullivan","year":"1996","journal-title":"Biol Blood Marrow Transplant."},{"key":"2020021221391000000_B23","doi-asserted-by":"crossref","first-page":"1054","DOI":"10.1182\/blood.V73.4.1054.1054","article-title":"Graft-v-host disease is associated with autoimmune-like thrombocytopenia.","volume":"73","author":"Anasetti","year":"1989","journal-title":"Blood."},{"key":"2020021221391000000_B24","first-page":"590a","article-title":"Chronic graft-versus-host disease (GVHD) following unrelated donor transplantation [abstract].","volume":"90","author":"Morton","year":"1997","journal-title":"Blood."},{"key":"2020021221391000000_B25","doi-asserted-by":"crossref","first-page":"65","DOI":"10.1038\/sj.bmt.1702717","article-title":"Acute bleeding and thrombocytopenia after bone marrow transplantation.","volume":"27","author":"Nevo","year":"2001","journal-title":"Bone Marrow Transplant."},{"key":"2020021221391000000_B26","first-page":"127","article-title":"Increased late complications of allogeneic and autologous marrow transplantation.","volume":"10","author":"Sullivan","year":"1992","journal-title":"Bone Marrow Transplant."},{"key":"2020021221391000000_B27","doi-asserted-by":"crossref","first-page":"461","DOI":"10.7326\/0003-4819-98-4-461","article-title":"Predictive factors in chronic graft-versus-host disease in patients with aplastic anemia treated by marrow transplantation from HLA-identical siblings.","volume":"98","author":"Storb","year":"1983","journal-title":"Ann Intern Med."},{"key":"2020021221391000000_B28","doi-asserted-by":"crossref","first-page":"555","DOI":"10.1182\/blood.V72.2.555.555","article-title":"Alternating-day cyclosporine and prednisone for treatment of high-risk chronic graft-versus-host 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