Graft-versus-host disease grading

Akpek G, Lee SJ, Flowers ME, et al. Performance of a new clinical grading system for chronic graft-versus-host disease a multicenter study. Blood 2003 102 802-809. 

Observational studies In 30 patients who underwent allogeneic stem-cell transplantation for leukemia and a retrospectively matched group of controls, the palifermin recipients who received a transplant from an unrelated donor had reduced severity, incidence, and duration of oral mucositis WHO grades 2—4, reduced need for opioid analgesics, and a shorter duration of total parenteral nutrition [15. However, there was no benefidal effect of palifermin on the incidence and severity of acute graft-versus-host disease. Febrile neutropenia. 

In a study of haematopoietic stem cell transplant for chronic granulomatous disease patients who were transplanted with either matched related donor (n=4) or matched unrelated donor (n=7), four patients experienced grade I skin acute graft-versus-host disease that responded to topical treatment and all were alive (between 1 and 8 years) after transplant [169 ]. 

In another related haploidentical transplant study, 20 patients with haematopoietic malignancies were studied [172 ]. Authors report tiiat all patients did engraft, cumulative incidences of grades II-IV and III-IV acute graft-versus-host disease were 30% and 10%, respectively whereas the incidence of chronic graft-versus-host disease was 35%. For standard-risk patients, the estimated 1-year overall survival and disease-free survival were 88% and 67%, respectively. 

Immunologic In a case series of 179 paediatric allogeneic haematopoietic stem cell transplants, they had a 48% incidence of grade O-I and 52% incidence of grade II-IV acute graft-versus-host disease [175 ]. Only malignant... 

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