title: Correlation between NIH composite skin score, patient-reported skin score, and outcome: results from the Chronic GVHD Consortium.
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.
authors: Division of Blood and Marrow Transplantation, Children's National Medical Center, Washington, DC, USA.
authors: David A
authors: DA
authors: Jacobsohn
authors: Brenda F
authors: BF
authors: Kurland
authors: Joseph
authors: J
authors: Pidala
authors: Yoshihiro
authors: Y
authors: Inamoto
authors: Xiaoyu
authors: X
authors: Chai
authors: Jeanne M
authors: JM
authors: Palmer
authors: Sally
authors: S
authors: Arai
authors: Mukta
authors: M
authors: Arora
authors: Madan
authors: M
authors: Jagasia
authors: Corey
authors: C
authors: Cutler
authors: Daniel
authors: D
authors: Weisdorf
authors: Paul J
authors: PJ
authors: Martin
authors: Steven Z
authors: SZ
authors: Pavletic
authors: Georgia
authors: G
authors: Vogelsang
authors: Stephanie J
authors: SJ
authors: Lee
authors: Mary E D
authors: ME
authors: Flowers
mesh_terms: D000293:Adolescent; D000328:Adult; D002908:Chronic Disease; D015975:Consensus Development Conferences, NIH as Topic; D005260:Female; D006086:Graft vs Host Disease / Q000150:complications / Q000175:diagnosis* / Q000401:mortality*; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D057566:Self Report; D012871:Skin Diseases / Q000209:etiology / Q000401:mortality* / Q000473:pathology*; D014481:United States; D055815:Young Adult