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Graft-Versus-Host Disease

Prevalence and risk factors associated with development of ocular GVHD defined by NIH consensus criteria

Bone Marrow Transplantation volume 47, pages 1470–1473 (2012)Cite this article

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Abstract

We studied 172 patients for development of ocular graft-versus-host disease (GVHD) after allogeneic stem cell transplantation (allo-SCT) from 2002 to 2009. Ocular GVHD was diagnosed in 60 patients (38%), with 27 (16%) being diagnosed at days 100 and 33 (23%) beyond day 100 for a 2-year cumulative incidence of 35% (95% confidence interval (CI), 28–43). The positive and negative predictive values of a Schirmer I test score (using ⩽5 mm as a cutoff) in predicting ocular GVHD (day 100) were 41 and 82%, respectively. In patients with ocular GVHD beyond day 100, extraocular manifestations of GVHD preceded the development of ocular GVHD in most patients (27 of 33, 81%). Prior acute skin GVHD (odds ratio 2.57, 95% CI 1.17–5.64, P=0.019) and male recipients of female donors (odds ratio 2.57, 95% CI 1.09–6.06, P=0.03) were independent risk factors for ocular GVHD. We recommend comprehensive ocular evaluation rather than a screening Schirmer's test to establish the diagnosis of ocular GVHD. Early diagnosis and preventive strategies in high-risk populations need to be studied in clinical trials to prevent devastating impact on quality of life in patients with prolonged ocular GVHD.

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Acknowledgements

Author contributions: RJ, BNS and MJ designed the study, coordinated data analyses and wrote the manuscript. UT did ocular evaluation and contributed to the manuscript. HC did statistical analyses. CC, CL and LAV provided care to patients in long-term transplant clinic. AK, BGE, JPG and SGG contributed to the manuscript.

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Authors and Affiliations

  1. Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA

    R Jacobs

  2. Department of Ophthalmology, Vanderbilt University Medical Center, Nashville, TN, USA

    U Tran

  3. Department of Biostatistics, Vanderbilt University Medical Center, Nashville, TN, USA

    H Chen

  4. Department of Medicine, Division of Hematology-Oncology, Vanderbilt University Medical Center, Nashville, TN, USA

    A Kassim, B G Engelhardt, J P Greer, S G Goodman, C Clifton, C Lucid, L A Vaughan, B N Savani & M Jagasia

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  1. R Jacobs
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Correspondence to M Jagasia.

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Jacobs, R., Tran, U., Chen, H. et al. Prevalence and risk factors associated with development of ocular GVHD defined by NIH consensus criteria. Bone Marrow Transplant 47, 1470–1473 (2012). https://doi.org/10.1038/bmt.2012.56

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