Faculty Collaboration Database

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. Biol Blood Marrow Transplant 2014 Mar;20(3):337-44

Date

12/10/2013

Pubmed ID

24315845

Pubmed Central ID

PMC3973401

DOI

10.1016/j.bbmt.2013.11.025

Scopus ID

2-s2.0-84896815699 (requires institutional sign-in at Scopus site)   71 Citations

Abstract

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.

Author List

Palmer J, Williams K, Inamoto Y, Chai X, Martin PJ, Tomas LS, Cutler C, Weisdorf D, Kurland BF, Carpenter PA, Pidala J, Pavletic SZ, Wood W, Jacobsohn D, Arai S, Arora M, Jagasia M, Vogelsang GB, Lee SJ

Author

Linus John H Santo Tomas MD Associate Professor in the Medicine department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adolescent
Adult
Child
Child, Preschool
Chronic Disease
Female
Graft vs Host Disease
Hematologic Neoplasms
Hematopoietic Stem Cell Transplantation
Humans
Lung
Male
National Institutes of Health (U.S.)
Patient Outcome Assessment
Proportional Hazards Models
Prospective Studies
Research Design
Respiratory Function Tests
Severity of Illness Index
Survival Analysis
Transplantation, Homologous
United States