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

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

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.

Publication types

  • Comparative Study
  • Research Support, N.I.H., Extramural

MeSH terms

  • Adolescent
  • Adult
  • Chronic Disease
  • Consensus Development Conferences, NIH as Topic
  • Female
  • Graft vs Host Disease / complications
  • Graft vs Host Disease / diagnosis*
  • Graft vs Host Disease / mortality*
  • Humans
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Prospective Studies
  • Self Report*
  • Skin Diseases / etiology
  • Skin Diseases / mortality*
  • Skin Diseases / pathology*
  • United States
  • Young Adult