TY - JOUR
T1 - Pulmonary symptoms measured by the national institutes of health lung score predict overall survival, nonrelapse mortality, and patient-reported outcomes in chronic graft-versus-host disease
AU - Palmer, Jeanne
AU - Williams, Kirsten
AU - Inamoto, Yoshihiro
AU - Chai, Xiaoyu
AU - Martin, Paul J.
AU - Tomas, Linus Santo
AU - Cutler, Corey
AU - Weisdorf, Daniel
AU - Kurland, Brenda F.
AU - Carpenter, Paul A.
AU - Pidala, Joseph
AU - Pavletic, Steven Z.
AU - Wood, William
AU - Jacobsohn, David
AU - Arai, Sally
AU - Arora, Mukta
AU - Jagasia, Madan
AU - Vogelsang, Georgia B.
AU - Lee, Stephanie J.
N1 - Funding Information:
This work was supported by grants CA118953 and CA163438 from the National Institutes of Health (NIH) . The Chronic GVHD Consortium ( U54 CA163438 ) is a part of the NIH Rare Diseases Clinical Research Network, supported through collaboration between the NIH Office of Rare Diseases Research at the National Center for Advancing Translational Science, the National Cancer Institute, and the Fred Hutchinson Cancer Research Center. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.
PY - 2014/3
Y1 - 2014/3
N2 - The 2005 National Institutes of Health (NIH) Consensus Conference recommended assessment of lung function in patients with chronic graft-versus-host disease (GVHD) by both pulmonary function tests (PFTs) and assessment of pulmonary symptoms. We tested whether pulmonary measures were associated with nonrelapse mortality (NRM), overall survival (OS), and patient-reported outcomes (PRO). Clinician and patient-reported data were collected serially in a prospective, multicenter, observational study. Available PFT data were abstracted. Cox regression models were fit for outcomes using a time-varying covariate model for lung function measures and adjusting for patient and transplantation characteristics and nonlung chronic GVHD severity. A total of 1591 visits (496 patients) were used in this analysis. The NIH symptom-based lung score was associated with NRM (P= .02), OS (P= .02), patient-reported symptoms (P < .001) and functional status (P < .001). Worsening of NIH symptom-based lung score over time was associated with higher NRM and lower survival. All other measures were not associated with OS or NRM; although, some were associated with patient-reported lung symptoms. In conclusion, the NIH symptom-based lung symptom score of 0 to 3 is associated with NRM, OS, and PRO measures in patients with chronic GVHD. Worsening of the NIH symptom-based lung score was associated with increased mortality.
AB - The 2005 National Institutes of Health (NIH) Consensus Conference recommended assessment of lung function in patients with chronic graft-versus-host disease (GVHD) by both pulmonary function tests (PFTs) and assessment of pulmonary symptoms. We tested whether pulmonary measures were associated with nonrelapse mortality (NRM), overall survival (OS), and patient-reported outcomes (PRO). Clinician and patient-reported data were collected serially in a prospective, multicenter, observational study. Available PFT data were abstracted. Cox regression models were fit for outcomes using a time-varying covariate model for lung function measures and adjusting for patient and transplantation characteristics and nonlung chronic GVHD severity. A total of 1591 visits (496 patients) were used in this analysis. The NIH symptom-based lung score was associated with NRM (P= .02), OS (P= .02), patient-reported symptoms (P < .001) and functional status (P < .001). Worsening of NIH symptom-based lung score over time was associated with higher NRM and lower survival. All other measures were not associated with OS or NRM; although, some were associated with patient-reported lung symptoms. In conclusion, the NIH symptom-based lung symptom score of 0 to 3 is associated with NRM, OS, and PRO measures in patients with chronic GVHD. Worsening of the NIH symptom-based lung score was associated with increased mortality.
KW - Bronchiolitis obliterans syndrome
KW - Chronic graft-versus-host disease
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U2 - 10.1016/j.bbmt.2013.11.025
DO - 10.1016/j.bbmt.2013.11.025
M3 - Article
C2 - 24315845
AN - SCOPUS:84896815699
SN - 1083-8791
VL - 20
SP - 337
EP - 344
JO - Biology of Blood and Marrow Transplantation
JF - Biology of Blood and Marrow Transplantation
IS - 3
ER -