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

Croat Med J. 2016 Jun 30;57(3):266-75. doi: 10.3325/cmj.2016.57.266.

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.

MeSH terms

  • Adult
  • Chronic Disease
  • Female
  • Graft vs Host Disease / blood
  • Graft vs Host Disease / physiopathology*
  • Hand Strength
  • Hematopoietic Stem Cell Transplantation*
  • Humans
  • Infant
  • Male
  • Middle Aged
  • Severity of Illness Index*
  • Walking