Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:

 

Early detection helps manage a chronic graft-vs.-host disease complication

07.03.2014

Simple, cost-effective questionnaire outperforms other tests in spotting lung involvement

A simple questionnaire that rates breathing difficulties on a scale of 0 to 3 predicts survival in chronic graft-vs.-host disease, according to a study published in the March issue of Biology of Blood and Marrow Transplantation.


Stephanie Lee, M.D., M.P.H., research director of Fred Hutchinson Cancer Research Center’s Long-Term Follow-Up Program, member of the Clinical Research Division at Fred Hutch and professor of oncology at the University of Washington School of Medicine. Photo by Suong Che / SCCA

And although a poor score means a higher risk of death, asking a simple question that can spot lung involvement early means that patients can begin treatments to reduce or manage symptoms, said senior author Stephanie Lee, M.D., M.P.H., research director of Fred Hutchinson Cancer Research Center’s Long-Term Follow-Up Program, member of the Clinical Research Division at Fred Hutch and professor of oncology at the University of Washington School of Medicine.

“It’s a warning,” said Lee, senior author of the study. “It puts us on notice to be more careful and attentive.”

... more about:
»Cancer »Chronic »GVHD »Health »breath »immune »lung »mortality »symptoms

GVHD is an immune reaction that occurs in some patients who have received bone marrow or blood cell transplants using donor cells. In GVHD, the transplanted cells — which will become the patient’s new immune system — attack the patient’s own cells as they would a foreign object or infection. GVHD can be either acute or chronic; severe, uncontrolled cases can be fatal.

Chronic GVHD most often involves the skin and mouth, but almost any other organ system can be involved. The likelihood of developing chronic GVHD is around 30 to 50 percent, said Lee. Of those who do develop it, about 15 to 20 percent will have lung involvement.

In 2005, the National Institutes of Health recommended assessment of lung function in patients with chronic GVHD using both pulmonary function tests — machines that measure air flow — and an assessment of symptoms.

The newly published study found that shortness of breath is associated with a higher risk of death overall and of nonrelapse mortality, and that worsening symptoms over time were associated with increased mortality. Researchers analyzed a total of 1,591 visits by 496 patients in multiple treatment centers.

One of the study’s findings was both surprising and encouraging: As a screening test, the simple questionnaire outperformed other tests, which the study called encouraging.

“The questionnaire turned out to be the most predictive,” Lee said. “It’s just a question, therefore easy to do and cost effective. No special equipment is involved.”

The NIH symptom-based lung score asks about breathing difficulties and assigns the following numbers: 0 for no symptoms, 1 for shortness of breath with stairs, 2 for shortness of breath on flat ground, and 3 for shortness of breath at rest or requiring oxygen.

Not surprisingly, a score of 3 (shortness of breath at rest or requiring oxygen) was associated with higher mortality. But, the study pointed out, even patients with an NIH symptom-based lung score of 1 (shortness of breath with stairs) had a worse outcome than those with a score of 0.

Again, Lee saw the result as a way to notice problems earlier and start treatment sooner.

The patient’s doctor would most likely follow up a poor score with other tests, such as a CT scan, to determine the cause; although chronic GVHD should always be suspected following a transplant, it is not the cause of every problem. The first line of treatment for chronic GVHD is medicines that suppress the immune system.

A poor score can also serve as a reminder to make sure the patient has had a pneumonia vaccination and is taking other precautions, Lee said.

The Fred Hutch Long-Term Follow-Up program is a lifelong monitoring and care program for bone marrow and stem cell transplant survivors.

The National Institutes of Health funded the research, which also involved researchers at the Medical College of Wisconsin, Children’s National Medical Center, Dana-Farber Cancer Institute, University of Minnesota, University of Pittsburgh, Moffitt Cancer Center, the National Institues of Health, Lineberger Comprehensive Cancer Center, Stanford University, Vanderbilt University and Johns Hopkins Hospital.  

Editor’s note: This news release was written by Fred Hutch staff writer/editor Mary Engel. To obtain a copy of the Biology of Blood and Marrow Transplantation paper, Pulmonary Symptoms Measured by the National Institutes of Health Lung Score Predict Overall Survival, Nonrelapse Mortality, and Patient-Reported Outcomes in Chronic Graft-Versus-Host Disease, or to arrange an interview with senior author Stephanie Lee, M.D., M.P.H., contact Kristen Woodward, media@fredhutch.org or 206-667-2210.

# # #

At Fred Hutchinson Cancer Research Center, home to three Nobel laureates, interdisciplinary teams of world-renowned scientists seek new and innovative ways to prevent, diagnose and treat cancer, HIV/AIDS and other life-threatening diseases. Fred Hutch’s pioneering work in bone marrow transplantation led to the development of immunotherapy, which harnesses the power of the immune system to treat cancer with minimal side effects. An independent, nonprofit research institute based in Seattle, Fred Hutch houses the nation’s first and largest cancer prevention research program, as well as the clinical coordinating center of the Women’s Health Initiative and the international headquarters of the HIV Vaccine Trials Network. Private contributions are essential for enabling Fred Hutch scientists to explore novel research opportunities that lead to important medical breakthroughs. For more information visit www.fredhutch.org or follow Fred Hutch on Facebook, Twitter or YouTube.

CONTACT
Kristen Woodward
206-667-2210
media@fredhutch.org

 

 

 

 

 

 

 

 

 

 

 

 

 
 
 

Kristen Woodward | EurekAlert!
Further information:
http://www.fredhutch.org

Further reports about: Cancer Chronic GVHD Health breath immune lung mortality symptoms

More articles from Health and Medicine:

nachricht Norovirus evades immune system by hiding out in rare gut cells
12.10.2017 | University of Pennsylvania School of Medicine

nachricht Flexible sensors can detect movement in GI tract
11.10.2017 | Massachusetts Institute of Technology

All articles from Health and Medicine >>>

The most recent press releases about innovation >>>

Die letzten 5 Focus-News des innovations-reports im Überblick:

Im Focus: Neutron star merger directly observed for the first time

University of Maryland researchers contribute to historic detection of gravitational waves and light created by event

On August 17, 2017, at 12:41:04 UTC, scientists made the first direct observation of a merger between two neutron stars--the dense, collapsed cores that remain...

Im Focus: Breaking: the first light from two neutron stars merging

Seven new papers describe the first-ever detection of light from a gravitational wave source. The event, caused by two neutron stars colliding and merging together, was dubbed GW170817 because it sent ripples through space-time that reached Earth on 2017 August 17. Around the world, hundreds of excited astronomers mobilized quickly and were able to observe the event using numerous telescopes, providing a wealth of new data.

Previous detections of gravitational waves have all involved the merger of two black holes, a feat that won the 2017 Nobel Prize in Physics earlier this month....

Im Focus: Smart sensors for efficient processes

Material defects in end products can quickly result in failures in many areas of industry, and have a massive impact on the safe use of their products. This is why, in the field of quality assurance, intelligent, nondestructive sensor systems play a key role. They allow testing components and parts in a rapid and cost-efficient manner without destroying the actual product or changing its surface. Experts from the Fraunhofer IZFP in Saarbrücken will be presenting two exhibits at the Blechexpo in Stuttgart from 7–10 November 2017 that allow fast, reliable, and automated characterization of materials and detection of defects (Hall 5, Booth 5306).

When quality testing uses time-consuming destructive test methods, it can result in enormous costs due to damaging or destroying the products. And given that...

Im Focus: Cold molecules on collision course

Using a new cooling technique MPQ scientists succeed at observing collisions in a dense beam of cold and slow dipolar molecules.

How do chemical reactions proceed at extremely low temperatures? The answer requires the investigation of molecular samples that are cold, dense, and slow at...

Im Focus: Shrinking the proton again!

Scientists from the Max Planck Institute of Quantum Optics, using high precision laser spectroscopy of atomic hydrogen, confirm the surprisingly small value of the proton radius determined from muonic hydrogen.

It was one of the breakthroughs of the year 2010: Laser spectroscopy of muonic hydrogen resulted in a value for the proton charge radius that was significantly...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

Event News

ASEAN Member States discuss the future role of renewable energy

17.10.2017 | Event News

World Health Summit 2017: International experts set the course for the future of Global Health

10.10.2017 | Event News

Climate Engineering Conference 2017 Opens in Berlin

10.10.2017 | Event News

 
Latest News

Ocean atmosphere rife with microbes

17.10.2017 | Life Sciences

Neutrons observe vitamin B6-dependent enzyme activity useful for drug development

17.10.2017 | Life Sciences

NASA finds newly formed tropical storm lan over open waters

17.10.2017 | Earth Sciences

VideoLinks
B2B-VideoLinks
More VideoLinks >>>