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      Vitamin D levels and their associations with survival and major disease outcomes in a large cohort of patients with chronic graft-vs-host disease

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          Abstract

          Aim

          To identify the factors associated with vitamin D status in patients with chronic graft-vs-host disease (cGVHD) and evaluate the association between serum vitamin D (25(OH)D) levels and cGVHD characteristics and clinical outcomes defined by the National Institutes of Health (NIH) criteria.

          Methods

          310 cGVHD patients enrolled in the NIH cGVHD natural history study (clinicaltrials.gov: NCT00092235) were analyzed. Univariate analysis and multiple logistic regression were used to determine the associations between various parameters and 25(OH)D levels, dichotomized into categorical variables: ≤20 and >20 ng/mL, and as a continuous parameter. Multiple logistic regression was used to develop a predictive model for low vitamin D. Survival analysis and association between cGVHD outcomes and 25(OH)D as a continuous as well as categorical variable: ≤20 and >20 ng/mL; <50 and ≥50 ng/mL, and among three ordered categories: ≤20, 20-50, and ≥50 ng/mL, was performed.

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          Most cited references25

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          Prediction of creatinine clearance from serum creatinine.

          Paige Gault, H Gault, D Cockcroft (1975)
          A formula has been developed to predict creatinine clearance (Ccr) from serum creatinine (Scr) in adult males: (see article)(15% less in females). Derivation included the relationship found between age and 24-hour creatinine excretion/kg in 249 patients aged 18-92. Values for Ccr were predicted by this formula and four other methods and the results compared with the means of two 24-hour Ccr's measured in 236 patients. The above formula gave a correlation coefficient between predicted and mean measured Ccr's of 0.83; on average, the difference predicted and mean measured values was no greater than that between paired clearances. Factors for age and body weight must be included for reasonable prediction.
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            Use of the scored Patient-Generated Subjective Global Assessment (PG-SGA) as a nutrition assessment tool in patients with cancer.

            J. Bauer, S Capra, M. Ferguson (2002)
            To evaluate the use of the scored Patient-Generated Subjective Global Assessment (PG-SGA) as a nutrition assessment tool in patients with cancer. An observational study assessing the nutritional status of patients with cancer. Oncology ward of a private tertiary Australian hospital. Seventy-one cancer patients aged 18-92 y. Scored PG-SGA questionnaire, comparison of scored PG-SGA with subjective global assessment (SGA), sensitivity, specificity. Some 24% (17) of 71 patients were well nourished, 59% (42) of patients were moderately or suspected of being malnourished and 17% (12) of patients were severely malnourished according to subjective global assessment (SGA). The PG-SGA score had a sensitivity of 98% and a specificity of 82% at predicting SGA classification. There was a significant difference in the median PG-SGA scores for each of the SGA classifications (P<0.001), with the severely malnourished patients having the highest scores. Re-admission within 30 days of discharge was significantly different between SGA groups (P=0.037). The mortality rate within 30 days of discharge was not significantly different between SGA groups (P=0.305). The median length of stay of well nourished patients (SGA A) was significantly lower than that of the malnourished (SGA B+C) patients (P=0.024). The scored PG-SGA is an easy to use nutrition assessment tool that allows quick identification and prioritisation of malnutrition in hospitalised patients with cancer.
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              Chronic graft-versus-host disease.

              Georgia Vogelsang, Brian J. Lee, Mary Flowers (2003)
              Chronic graft-versus-host disease (GVHD) remains a vexing and dangerous complication of allogeneic stem cell transplantation. Mild forms of chronic GVHD are often manageable with local or low-dose systemic immunosuppression and do not affect long-term survival. In contrast, more severe forms of chronic GVHD require intensive medical management and adversely affect survival. This report reviews current concepts of the pathogenesis, clinical risk factors, classification systems, organ manifestations, and available treatments for chronic GVHD. It also provides a comprehensive listing of the published clinical trials aimed at prevention and primary treatment of chronic GVHD. Copyright 2003 American Society for Blood and Marrow Transplantation
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                Author and article information

                Journal
                Journal ID (nlm-ta): Croat Med J
                Journal ID (iso-abbrev): Croat. Med. J
                Journal ID (publisher-id): CMJ
                Title: Croatian Medical Journal
                Publisher: Croatian Medical Schools
                ISSN (Print): 0353-9504
                ISSN (Electronic): 1332-8166
                Publication date (Print): June 2016
                Volume: 57
                Issue: 3
                Pages: 276-286
                Affiliations
                [1 ]Experimental Transplantation and Immunology Branch, NCI, NIH, Bethesda, MD, USA
                [2 ]Jamnica d.d., Zagreb, Croatia
                [3 ]Biostatistics and Data Management Section, NCI, NIH, Rockville, MD, USA
                [4 ]Clinical Nutrition Department, Clinical Center, NIH, Bethesda, MD, USA
                [5 ]Division of Hematology, Department of Internal Medicine, University Hospital Center Zagreb, Zagreb, Croatia
                [6 ]Medical School University of Zagreb, Zagreb, Croatia
                [7 ]Faculty of Medicine Osijek, J.J. Strossmayer University of Osijek, Osijek, Croatia
                [8 ]Center for Cancer Research, NIH, Bethesda, MD, USA
                Author notes
                Correspondence to:
Mašenjka Katić
Trg 101. brigade HV 2
Zagreb, Croatia
 mashakatic@ 123456gmail.com
                Article
                Publisher ID: CroatMedJ_57_0276
                DOI: 10.3325/cmj.2016.57.276
                PMC ID: 4937226
                PubMed ID: 27374829
                SO-VID: 438b8000-43ed-431d-85db-0df111e1ecd5
                Copyright © Copyright © 2016 by the Croatian Medical Journal. All rights reserved.
                License:

                This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                Date received : 02 February 2016
                Date accepted : 06 June 2016
                Categories
                Subject: Graft-VS-Host Disease

                ScienceOpen disciplines: Medicine
                Data availability:
                ScienceOpen disciplines: Medicine

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