title: Hand grip strength and 2-minute walk test in chronic graft-versus-host disease assessment: analysis from the Chronic GVHD Consortium.
abstract: Hand grip strength (HGS) and the 2-minute walk test (2MWT) have been proposed as elements of chronic graft-versus-host disease (GVHD) assessment in clinical trials. Using all available data (n = 584 enrollment visits, 1689 follow-up visits, total of 2273 visits) from a prospective observational cohort study, we explored the relationship between HGS and 2MWT and patient-reported measures (Lee symptom scale, MOS 36-Item Short-Form Health Survey [SF-36], and Functional Assessment of Cancer Therapy [FACT]-Bone Marrow Transplantation quality of life instruments and Human Activity Profile [HAP]), chronic GVHD global severity (National Institutes of Health global score, clinician global score, and patient-reported global score), calculated and clinician-reported chronic GVHD response, and mortality (overall survival, nonrelapse mortality, and failure-free survival) in multivariable analyses adjusted for significant covariates. 2MWT was significantly associated with intuitive domains of the Lee Symptom Scale (overall, skin, lung, energy), SF-36 domain and summary scores, FACT summary and domain scores, and HAP scores (all P < .001). Fewer associations were detected with the HGS. The 2MWT and HGS both had significant association with global chronic GVHD severity. In multivariable analysis, 2MWT was significantly associated with overall survival, nonrelapse mortality, and failure-free survival, whereas no association was found for HGS. 2MWT and HGS were not sensitive to National Institutes of Health or clinician-reported response. Based on independent association with mortality, these data support the importance of the 2MWT for identification of high-risk chronic GVHD patients. However, change in 2MWT is not sensitive to chronic GVHD response, limiting its usefulness in clinical trials.
authors.affiliation: H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida 33612, USA. Joseph.pidala@moffitt.org
authors.forename: Joseph
authors.initials: J
authors.lastname: Pidala
authors.forename: Xiaoyu
authors.initials: X
authors.lastname: Chai
authors.forename: Paul
authors.initials: P
authors.lastname: Martin
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Inamoto
authors.forename: Corey
authors.initials: C
authors.lastname: Cutler
authors.forename: Jeanne
authors.initials: J
authors.lastname: Palmer
authors.forename: Daniel
authors.initials: D
authors.lastname: Weisdorf
authors.forename: Steven
authors.initials: S
authors.lastname: Pavletic
authors.forename: Mukta
authors.initials: M
authors.lastname: Arora
authors.forename: Madan
authors.initials: M
authors.lastname: Jagasia
authors.forename: David
authors.initials: D
authors.lastname: Jacobsohn
authors.forename: Stephanie J
authors.initials: SJ
authors.lastname: Lee
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000032:analysis; D002648:Child; D002675:Child, Preschool; D002908:Chronic Disease; D005260:Female; D006086:Graft vs Host Disease / Q000175:diagnosis* / Q000276:immunology / Q000401:mortality / Q000628:therapy*; D018737:Hand Strength; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011446:Prospective Studies; D011788:Quality of Life; D012008:Recurrence; D012720:Severity of Illness Index; D016019:Survival Analysis; D014184:Transplantation, Homologous; D016896:Treatment Outcome; D016138:Walking
chemical_list: D015415:Biomarkers
references.citation: Haematologica. 2011 Oct;96(10):1528-35
references.pmid: 21685473
references.citation: J Orthop Res. 1988;6(2):215-22
references.pmid: 3343627
references.citation: Arch Phys Med Rehabil. 1985 Feb;66(2):69-74
references.pmid: 3970660
references.citation: Med Care. 1993 Mar;31(3):247-63
references.pmid: 8450681
references.citation: Chest. 2006 Jul;130(1):119-25
references.pmid: 16840391
references.citation: Support Care Cancer. 2013 Apr;21(4):1121-9
references.pmid: 23111942
references.citation: Arch Phys Med Rehabil. 1982 Dec;63(12):620-2
references.pmid: 7149948
references.citation: Clin Nutr. 2011 Apr;30(2):135-42
references.pmid: 21035927
references.citation: Hematology Am Soc Hematol Educ Program. 2008;:134-41
references.pmid: 19074071
references.citation: Tex Heart Inst J. 2007;34(2):166-9
references.pmid: 17622362
references.citation: Clinics (Sao Paulo). 2012;67(6):581-6
references.pmid: 22760895
references.citation: Physiotherapy. 2012 Dec;98(4):277-86
references.pmid: 23122432
references.citation: J Hematother Stem Cell Res. 2003 Apr;12(2):237-42
references.pmid: 12804182
references.citation: Biol Blood Marrow Transplant. 2011 Aug;17(8):1114-20
references.pmid: 21664473
references.citation: Chest. 2008 Oct;134(4):746-752
references.pmid: 18625667
references.citation: Blood. 2009 Jul 2;114(1):7-19
references.pmid: 19336756
references.citation: Biol Blood Marrow Transplant. 2006 Apr;12(4):375-96
references.pmid: 16545722
references.citation: Biomed Pharmacother. 2012 Jun;66(4):266-70
references.pmid: 22560458
references.citation: Bone Marrow Transplant. 1997 Feb;19(4):357-68
references.pmid: 9051246
references.citation: Intern Med J. 2009 Aug;39(8):495-501
references.pmid: 19732197
references.citation: Blood. 2011 Apr 28;117(17):4651-7
references.pmid: 21355084
references.citation: Biol Blood Marrow Transplant. 2002;8(8):444-52
references.pmid: 12234170
references.citation: BMJ. 2010 Sep 09;341:c4467
references.pmid: 20829298
references.citation: Blood. 2011 Oct 13;118(15):4242-9
references.pmid: 21791424
references.citation: Biol Blood Marrow Transplant. 2005 Dec;11(12):945-56
references.pmid: 16338616
references.citation: Nephrol Dial Transplant. 2011 Nov;26(11):3588-95
references.pmid: 21444362
references.citation: Blood. 2004 Dec 1;104(12):3501-6
references.pmid: 15292060
references.citation: Biol Blood Marrow Transplant. 2010 Dec;16(12):1707-17
references.pmid: 20541028
references.citation: Biol Blood Marrow Transplant. 2006 Jan;12(1):31-47
references.pmid: 16399567
references.citation: Prim Care Respir J. 2011 Sep;20(3):269-75
references.pmid: 21523316
references.citation: Biol Blood Marrow Transplant. 2006 Feb;12(2):126-37
references.pmid: 16443511
references.citation: Biol Blood Marrow Transplant. 2006 Mar;12(3):252-66
references.pmid: 16503494
references.citation: J Hand Surg Am. 1984 Mar;9(2):222-6
references.pmid: 6715829
references.citation: Biol Blood Marrow Transplant. 2006 May;12(5):491-505
references.pmid: 16635784