Joint and fascial chronic graft-vs-host disease: correlations with clinical and laboratory parameters

Vukić, Tamara and Smith, Sean Robinson and Ljubas Kelečić, Dina and Desnica, Lana and Prenc, Ema and Pulanić, Dražen and Vrhovac, Radovan and Nemet, Damir and Pavletic, Steven Z. (2016) Joint and fascial chronic graft-vs-host disease: correlations with clinical and laboratory parameters. Croatian Medical Journal, 57 (3). pp. 266-275. ISSN 0353-9504

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Abstract

AIM: To determine if there are correlations between joint and fascial chronic graft-vs-host disease (cGVHD) with clinical findings, laboratory parameters, and measures of functional capacity. ----- METHODS: 29 patients were diagnosed with cGVHD based on National Institutes of Health (NIH) Consensus Criteria at the University Hospital Centre Zagreb from October 2013 to October 2015. Physical examination, including functional measures such as 2-minute walk test and hand grip strength, as well as laboratory tests were performed. The relationship between these evaluations and the severity of joint and fascial cGVHD was tested by logistical regression analysis. ----- RESULTS: 12 of 29 patients (41.3%) had joint and fascial cGVHD diagnosed according to NIH Consensus Criteria. There was a significant positive correlation of joint and fascial cGVHD and skin cGVHD (P<0.001), serum C3 complement level (P=0.045), and leukocytes (P=0.032). There was a significant negative correlation between 2-minute walk test (P=0.016), percentage of cytotoxic T cells CD3+/CD8+ (P=0.022), serum albumin (P=0.047), and Karnofsky score (P<0.001). Binary logistic regression model found that a significant predictor for joint and fascial cGVHD was cGVHD skin involvement (odds ratio, 7.79; 95 confidence interval 1.87-32.56; P=0.005). ----- CONCLUSION: Joint and fascial cGVHD manifestations correlated with multiple laboratory measurements, clinical features, and cGVHD skin involvement, which was a significant predictor for joint and fascial cGVHD.

Abstract in Croatian

Bolest presatka protiv domaćina zglobova i fascija: korelacije s kliničkim i laboratorijskim parametrima ----- Cilj: Odrediti postoje li korelacije između kronične bolesti presatka protiv domaćina (prema engl. chronic graft-versus-host disease, cGVHD) zglobova i fascija i kliničkih nalaza, laboratorijskih parametara i mjera funkcionalnog kapaciteta. ----- Postupci: U Kliničkom bolničkom centru "Zagreb" između listopada 2013. i listopada 2015, 29 pacijenata dijagnosticirana je cGVHD prema Konsenzusnim kriterijima Nacionalnih instituta za zdravlje SAD-a (prema engl. National Institutes of Health, NIH). Liječnički pregled uključio je funkcionalne mjere kao što su dvominutni test hodanja i snage stiska šake, a napravljeni su i laboratorijski testovi. Odnos između ovih vrijednosti i jačine cGVHD zglobova i fascija testiran je logističkom regresijskom analizom. ----- Rezultati: 12 od 29 pacijenata (41,3%) imalo je cGVHD zglobova i fascija dijagnosticiranu prema Konsenzusnim kriterijima NIH. Postojala je značajna pozitivna korelacija između cGVHD zglobova i fascija i cGVHD kože (P < 0,001), serumske razine C3 komplementa (P= 0,045) te broja leukocita (P= 0,032). Postojala je i značajna negativna korelacija između dvominutnog testa hodanja (P=0,16), postotka citotoksičnih T limfocita CD3+/CD8+ (P= 0,022), serumskog albumina (P= 0,047) i izračuna prema Karnofskom (P <0,001). Binarna logistička regresija pokazala je da je cGVHD kože bio značajan prediktor cGVHD zglobova i fascija (omjer ishoda, 7,79; 95 raspon pouzdanosti 1,87-32,56; P=0,005). ----- Zaključak: cGVHD zglobova i fascija korelirao je s nekoliko laboratorijskih vrijednosti, kliničkih obilježja i cGVHD kože. cGVHD kože se također pokazala kao značajan prediktor cGVHD zglobova i fascija.

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