An investigation of the diagnostic, predictive, and prognostic impacts of three colonic biopsy grading systems for acute graft versus host disease.

Acute graft versus host disease (aGvHD) is an important, life-threatening complication after allogeneic hematopoietic stem cell transplantation (alloHSCT). To investigate the value of multiple simultaneous colon biopsies in improving diagnostic accuracy in patients with aGvHD, we retrospectively ana...

Descripción completa

Guardado en:

Detalles Bibliográficos
Autores principales:	Andreas Kreft, Katrin Hippe, Eva Maria Wagner-Drouet, Isabelle Ries, Arne Kandulski, Maike Büttner-Herold, Helmut Neumann, Daniela Weber, Ernst Holler, Mario Schindeldecker
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/2bcd643cba4041b1992eac8e398af278
Etiquetas:	Agregar Etiqueta Sin Etiquetas, Sea el primero en etiquetar este registro!

id	oai:doaj.org-article:2bcd643cba4041b1992eac8e398af278
record_format	dspace
spelling	oai:doaj.org-article:2bcd643cba4041b1992eac8e398af2782021-12-02T20:19:31ZAn investigation of the diagnostic, predictive, and prognostic impacts of three colonic biopsy grading systems for acute graft versus host disease.1932-620310.1371/journal.pone.0256543https://doaj.org/article/2bcd643cba4041b1992eac8e398af2782021-01-01T00:00:00Zhttps://doi.org/10.1371/journal.pone.0256543https://doaj.org/toc/1932-6203Acute graft versus host disease (aGvHD) is an important, life-threatening complication after allogeneic hematopoietic stem cell transplantation (alloHSCT). To investigate the value of multiple simultaneous colon biopsies in improving diagnostic accuracy in patients with aGvHD, we retrospectively analyzed 157 patients after alloHSCT. The biopsies were evaluated individually using three established histological grading systems (Lerner, Sale, and Melson). The maximum, minimum, median, and mean histological aGvHD grades were calculated for each patient, and the results were correlated with the Glucksberg grade of clinical manifestation of GvHD, steroid therapy status, and outcome. We found that multiple colon biopsies enhanced diagnostic sensitivity. Moreover, higher histological grades correlated with steroid therapy initiation and refractoriness; the latter particularly occurred when advanced damage was present in all samples and healthy colon mucosa was reduced or absent. On multivariate analysis, the minimal Lerner and Glucksberg grades for intestinal aGvHD were significantly associated with steroid treatment failure. Ninety-nine patients died. The median survival was 285 days after the biopsies were taken. Fifteen patients died from relapse of their underling disorder and 84 from other causes, mostly infection (53 patients) and GvHD (14 patients). Multivariate analysis revealed a significant association between none-relapse mortality and the mean Lerner grade, minimum Melson grade, Glucksberg organ stage, and platelet counts. Thus, we found the Lerner system to be superior to the other grading methods in most instances and histologic evaluation of multiple simultaneously obtained biopsies from the colon to result in a higher diagnostic yield, which helps plan systemic steroid treatment while predicting treatment response and outcome.Andreas KreftKatrin HippeEva Maria Wagner-DrouetIsabelle RiesArne KandulskiMaike Büttner-HeroldHelmut NeumannDaniela WeberErnst HollerMario SchindeldeckerPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 16, Iss 8, p e0256543 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Andreas Kreft Katrin Hippe Eva Maria Wagner-Drouet Isabelle Ries Arne Kandulski Maike Büttner-Herold Helmut Neumann Daniela Weber Ernst Holler Mario Schindeldecker An investigation of the diagnostic, predictive, and prognostic impacts of three colonic biopsy grading systems for acute graft versus host disease.
description	Acute graft versus host disease (aGvHD) is an important, life-threatening complication after allogeneic hematopoietic stem cell transplantation (alloHSCT). To investigate the value of multiple simultaneous colon biopsies in improving diagnostic accuracy in patients with aGvHD, we retrospectively analyzed 157 patients after alloHSCT. The biopsies were evaluated individually using three established histological grading systems (Lerner, Sale, and Melson). The maximum, minimum, median, and mean histological aGvHD grades were calculated for each patient, and the results were correlated with the Glucksberg grade of clinical manifestation of GvHD, steroid therapy status, and outcome. We found that multiple colon biopsies enhanced diagnostic sensitivity. Moreover, higher histological grades correlated with steroid therapy initiation and refractoriness; the latter particularly occurred when advanced damage was present in all samples and healthy colon mucosa was reduced or absent. On multivariate analysis, the minimal Lerner and Glucksberg grades for intestinal aGvHD were significantly associated with steroid treatment failure. Ninety-nine patients died. The median survival was 285 days after the biopsies were taken. Fifteen patients died from relapse of their underling disorder and 84 from other causes, mostly infection (53 patients) and GvHD (14 patients). Multivariate analysis revealed a significant association between none-relapse mortality and the mean Lerner grade, minimum Melson grade, Glucksberg organ stage, and platelet counts. Thus, we found the Lerner system to be superior to the other grading methods in most instances and histologic evaluation of multiple simultaneously obtained biopsies from the colon to result in a higher diagnostic yield, which helps plan systemic steroid treatment while predicting treatment response and outcome.
format	article
author	Andreas Kreft Katrin Hippe Eva Maria Wagner-Drouet Isabelle Ries Arne Kandulski Maike Büttner-Herold Helmut Neumann Daniela Weber Ernst Holler Mario Schindeldecker
author_facet	Andreas Kreft Katrin Hippe Eva Maria Wagner-Drouet Isabelle Ries Arne Kandulski Maike Büttner-Herold Helmut Neumann Daniela Weber Ernst Holler Mario Schindeldecker
author_sort	Andreas Kreft
title	An investigation of the diagnostic, predictive, and prognostic impacts of three colonic biopsy grading systems for acute graft versus host disease.
title_short	An investigation of the diagnostic, predictive, and prognostic impacts of three colonic biopsy grading systems for acute graft versus host disease.
title_full	An investigation of the diagnostic, predictive, and prognostic impacts of three colonic biopsy grading systems for acute graft versus host disease.
title_fullStr	An investigation of the diagnostic, predictive, and prognostic impacts of three colonic biopsy grading systems for acute graft versus host disease.
title_full_unstemmed	An investigation of the diagnostic, predictive, and prognostic impacts of three colonic biopsy grading systems for acute graft versus host disease.
title_sort	investigation of the diagnostic, predictive, and prognostic impacts of three colonic biopsy grading systems for acute graft versus host disease.
publisher	Public Library of Science (PLoS)
publishDate	2021
url	https://doaj.org/article/2bcd643cba4041b1992eac8e398af278
work_keys_str_mv	AT andreaskreft aninvestigationofthediagnosticpredictiveandprognosticimpactsofthreecolonicbiopsygradingsystemsforacutegraftversushostdisease AT katrinhippe aninvestigationofthediagnosticpredictiveandprognosticimpactsofthreecolonicbiopsygradingsystemsforacutegraftversushostdisease AT evamariawagnerdrouet aninvestigationofthediagnosticpredictiveandprognosticimpactsofthreecolonicbiopsygradingsystemsforacutegraftversushostdisease AT isabelleries aninvestigationofthediagnosticpredictiveandprognosticimpactsofthreecolonicbiopsygradingsystemsforacutegraftversushostdisease AT arnekandulski aninvestigationofthediagnosticpredictiveandprognosticimpactsofthreecolonicbiopsygradingsystemsforacutegraftversushostdisease AT maikebuttnerherold aninvestigationofthediagnosticpredictiveandprognosticimpactsofthreecolonicbiopsygradingsystemsforacutegraftversushostdisease AT helmutneumann aninvestigationofthediagnosticpredictiveandprognosticimpactsofthreecolonicbiopsygradingsystemsforacutegraftversushostdisease AT danielaweber aninvestigationofthediagnosticpredictiveandprognosticimpactsofthreecolonicbiopsygradingsystemsforacutegraftversushostdisease AT ernstholler aninvestigationofthediagnosticpredictiveandprognosticimpactsofthreecolonicbiopsygradingsystemsforacutegraftversushostdisease AT marioschindeldecker aninvestigationofthediagnosticpredictiveandprognosticimpactsofthreecolonicbiopsygradingsystemsforacutegraftversushostdisease AT andreaskreft investigationofthediagnosticpredictiveandprognosticimpactsofthreecolonicbiopsygradingsystemsforacutegraftversushostdisease AT katrinhippe investigationofthediagnosticpredictiveandprognosticimpactsofthreecolonicbiopsygradingsystemsforacutegraftversushostdisease AT evamariawagnerdrouet investigationofthediagnosticpredictiveandprognosticimpactsofthreecolonicbiopsygradingsystemsforacutegraftversushostdisease AT isabelleries investigationofthediagnosticpredictiveandprognosticimpactsofthreecolonicbiopsygradingsystemsforacutegraftversushostdisease AT arnekandulski investigationofthediagnosticpredictiveandprognosticimpactsofthreecolonicbiopsygradingsystemsforacutegraftversushostdisease AT maikebuttnerherold investigationofthediagnosticpredictiveandprognosticimpactsofthreecolonicbiopsygradingsystemsforacutegraftversushostdisease AT helmutneumann investigationofthediagnosticpredictiveandprognosticimpactsofthreecolonicbiopsygradingsystemsforacutegraftversushostdisease AT danielaweber investigationofthediagnosticpredictiveandprognosticimpactsofthreecolonicbiopsygradingsystemsforacutegraftversushostdisease AT ernstholler investigationofthediagnosticpredictiveandprognosticimpactsofthreecolonicbiopsygradingsystemsforacutegraftversushostdisease AT marioschindeldecker investigationofthediagnosticpredictiveandprognosticimpactsofthreecolonicbiopsygradingsystemsforacutegraftversushostdisease
_version_	1718374156299403264

An investigation of the diagnostic, predictive, and prognostic impacts of three colonic biopsy grading systems for acute graft versus host disease.

Ejemplares similares