Clinical versus histological grading in the assessment of cutaneous graft versus host disease

Autor: M. R. van Dijk, J. Kuball, Marieke C H Hogenes, D. C. van der Valk, L. C. J. te Boome, R.A. de Weger, P. J. Van Diest
Jazyk: angličtina
Rok vydání: 2019
Předmět:
Male
Biopsy
Graft vs Host Disease
lcsh:Medicine
030204 cardiovascular system & hematology
Graft versus host disease
Gastroenterology
0302 clinical medicine
immune system diseases
hemic and lymphatic diseases
030212 general & internal medicine
Young adult
Child
Medicine(all)
integumentary system
medicine.diagnostic_test
General Medicine
Middle Aged
Prognosis
Skin diseases
surgical procedures
operative
Graft vs Host Disease/pathology
Child
Preschool
Acute Disease
Female
Adult
medicine.medical_specialty
Histology
Adolescent
Concordance
03 medical and health sciences
Young Adult
Internal medicine
medicine
Journal Article
Humans
Comparative Study
Preschool
Grading (tumors)
Aged
business.industry
Research
lcsh:R
Infant
Newborn
Infant
Retrospective cohort study
Newborn
medicine.disease
Grading
Graft-versus-host disease
Skin biopsy
Chronic Disease
business
Zdroj: European Journal of Medical Research, Vol 24, Iss 1, Pp 1-10 (2019)
European Journal of Medical Research
European Journal of Medical Research, 24(1), 19. BioMed Central
ISSN: 0949-2321
Popis: Background Skin biopsies are often used in daily practice for the diagnosis of acute (aGvHD) or chronic graft versus host disease (cGvHD). With the latest understanding in pathogenesis and new National Institute of Health (NIH) classifications for aGvHD and cGvHD, there is a need to evaluate the current prognostic value of histological grading cutaneous GvHD and its correlation to the clinical grade. Methods In a retrospective study with 120 skin biopsies (all taken for suspected GvHD) from 110 patients (all classified according to the NIH), biopsies were revised and graded, blinded for clinical information, for either acute of chronic features. Morphological grades were compared for concordance with the clinical grade and survival analyses were done for clinical and histological grading. Results Correlation for histologic vs. clinical grading was (very) poor for aGvHD and cGvHD (weighted κ − 0.038 and 0.0009, respectively). Patients with clinical aGvHD had worse prognosis compared to cGvHD. However, at time of biopsy neither clinical nor histological grading predicted the eventual survival for either aGvHD (p = 0.9739 and p = 0.0744, respectively) or cGvHD (p = 0.2149 and p = 0.4465, respectively). Conclusions Confirming the diagnosis of GvHD is still a valuable reason for taking a skin biopsy, but this study shows that histologic grading of GvHD in the skin biopsy has no additional value for clinicians in current practice. Electronic supplementary material The online version of this article (10.1186/s40001-019-0377-6) contains supplementary material, which is available to authorized users.
Databáze: OpenAIRE
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