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Comparative Study
. 2012 Sep 27;120(13):2545-52; quiz 2774.
doi: 10.1182/blood-2012-04-424135. Epub 2012 Jul 6.

Correlation between NIH composite skin score, patient-reported skin score, and outcome: results from the Chronic GVHD Consortium

David A Jacobsohn  1 , Brenda F Kurland, Joseph Pidala, Yoshihiro Inamoto, Xiaoyu Chai, Jeanne M Palmer, Sally Arai, Mukta Arora, Madan Jagasia, Corey Cutler, Daniel Weisdorf, Paul J Martin, Steven Z Pavletic, Georgia Vogelsang, Stephanie J Lee, Mary E D Flowers
Affiliations
Comparative Study

Correlation between NIH composite skin score, patient-reported skin score, and outcome: results from the Chronic GVHD Consortium

David A Jacobsohn et al. Blood. .

Abstract

There are no validated criteria to measure skin response in chronic GVHD. In a prospectively assembled, multicenter cohort of patients with chronic GVHD (N = 458), we looked for correlation of change in several different scales recommended by the National Institutes of Health (NIH) Consensus with clinician and patient perception of change and overall survival. Of the clinician scales, the NIH composite 0-3 skin score was the only one that correlated with both clinician and patient perception of improvement or worsening. Of the patient-reported scales, the skin subscale of the Lee Symptom Scale was the only one that correlated with both clinician and patient perception of improvement or worsening. At study entry, NIH skin score 3 and Lee skin symptom score > 15 were both associated with worse overall survival. Worsening of NIH skin score at 6 months was associated with worse overall survival. Improvement in the Lee skin symptom score at 6 months was associated with improved overall survival. Our findings support the use of the NIH composite 0-3 skin score and the Lee skin symptom score as simple and sensitive measures to evaluate skin involvement in clinical trials as well as in the clinical monitoring of patients with cutaneous chronic GVHD.

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Figures

Figure 1
Figure 1
Cutaneous manifestations of chronic GVHD by NIH skin response criteria, for 257 (56%) of 457 cases with skin involvement at enrollment. *Any skin GVHD type except sclerosis/fasciitis.
Figure 2
Figure 2
Outcomes according to baseline NIH skin score and Lee skin score. (A) Overall survival and (B) nonrelapse mortality according to baseline NIH composite 0-3 skin score. (C) Overall survival and (D) nonrelapse mortality according to baseline Lee skin symptom score.
See this image and copyright information in PMC

Comment in

References

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