Graft-versus-host disease epidemiology and demographics: Difference between revisions
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===Incidence=== | ===Incidence=== | ||
*In developing countries, the incidence of GvHD is not known since bone marrow transplants occur only in highly specialized centers. | |||
===Case Fatality Rate=== | ===Case Fatality Rate=== | ||
Revision as of 03:13, 4 July 2017
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Graft-versus-host disease |
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Differentiating Graft-versus-host disease from other Diseases |
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Shyam Patel [2]
Overview
There are no racial or geographic disparities regarding the prevalence of GvHD. GvHD carries a high morbidity rate across all subgroups of patients.
Epidemiology and Demographics
GvHD affects 30-70% of patients who undergo allogeneic transplant.[1] It accounts for 15-30% of deaths after stem cell transplant.[2] It is not an uncommon complication of stem cell transplant. It tends to occur more often in patients who have less genetic similarity compared to their donors. It typically occurs within the first 100 days of transplant (acute GvHD) (approximately 90-95% of cases), though it can also occur after the 100-day time point (chronic GvHD).[1] It is thought to occur more commonly in men and in patients who receive donor stem cells from female multiparous donors, as there is a higher probability for HLA disparity in this group. There are no specific racial disparities in GvHD. It can occur in persons of any race.
The Center for International Blood and Marrow Transplant Research performed an analysis of data collected between 1999 and 2005 showing that the overall incidence of grades 2-4 GvHD was 39% in patients who received stem cells from sibling donors and 59% in patients who received stem cells from unrelated donors.[3] It is important to note that the incidence of GvHD varies depending on the aggressiveness of diagnostic workup. If clinicians pursue diagnostic strategies like such as skin biopsy, liver biopsy, endoscopy, or colonoscopy even with minimal symptoms, a pathologic diagnosis may be present and a patient may be diagnosed with GvHD.[3]
Overview
- The prevalence of GvHD is estimated to be 5500 cases annually.[4]
- Patients of all age groups may develop GvHD, but it occurs more commonly in older persons who receive stem cells from female donors.
- GvHD affects men more commonly than women.
- There is no racial predilection to GvHD.
- The incidence of GvHD is not directly correlated with age, as the disease is an iatrogenic condition that occurs after a transplant, rather than a natural disease.
Epidemiology and Demographics
Prevalence
- Worldwide, the prevalence of GvHD is ranges from a low of 8x10^-7 per 100,000 persons to a high of 1.14x10-6 per 100,000 persons with an average prevalence of 9.5x10-7 per 100,000 persons. The reason for the low prevalence worldwide is that the disease can only occur after a bone marrow transplantation, and bone marrow transplantations occur only in highly specialized centers.
- In developing countries, the prevalence of GvHD has not been studied, as bone marrow transplants are only performed in highly specialized centers.
- In 2003, the prevalence of GvHD was estimated to range from 4795 to 6850 total cases worldwide.
Incidence
- In developing countries, the incidence of GvHD is not known since bone marrow transplants occur only in highly specialized centers.
Case Fatality Rate
- The case fatality rate is defined the number of deaths (fatality) among patients with the disease (case). Case fatality rate should be distinguished from "Mortality Rate" (defined as the number of deaths among the at-risk population).
- The case fatality rate is usually described as a function of time (e.g. In 2015 / annually etc...).
- When using numbers with decimal points, avoid reporting more than 1 number after the decimal point. For example, report the case fatality rate as 10.1% instead of 10.09322%. Many numbers after the decimal point may suggest a false sense of accuracy.
- You can pick the template sentence below for this section:
- In ____ (year), the case fatality rate of ____ (disease name) is ____ (case fatality rate in %).
- The annual case fatality rate of ____ (disease name) is approximately ____ (case fatality rate in %).
Age
- This section can describe the impact of the disease depending on the persons age, and the age-specific prevalence and incidence.
- The prevalence of ____ (insert disease state here) increases/decreases with age.
- _____ (insert acute disease) commonly affects _____ (insert age group).
- _____ (insert chronic disease) is usually first diagnosed among _____ (insert age group).
Gender
This section describe how prevalence of the disease varies by gender. When describing male to female ratios with decimal points, avoid reporting more than 1 number after the decimal point. For example, report a ratio as as 1.5 to 1 instead of 1.48294 to 1. Many numbers after the decimal point may suggest a false sense of accuracy. You can use either of the following template sentences:
- ______ (insert gender 1) are more commonly affected with ______ (insert disease name) than _____ (insert gender 2). The _____ (insert gender ratio e.g. male to female) ratio is approximately _____ (insert number > 1) to 1.
- The prevalence and incidence of (insert disease state here) does not vary by gender.
- Men and women are affected equally by (insert disease name here).
- (Insert disease state here) is more prevalent in men women.
- The prevalence of (insert disease state here) among men is ____ per 100,000, while it is _____ per 100,000 among women.
- The incidence of (insert disease state here) among men is ____ per 100,000, while it is _____ per 100,000 among women.
Race
- The prevalence of GvHD does not vary by race.
References
- ↑ 1.0 1.1 Lee SJ (2010). "Have we made progress in the management of chronic graft-vs-host disease?". Best Pract Res Clin Haematol. 23 (4): 529–35. doi:10.1016/j.beha.2010.09.016. PMC 3053022. PMID 21130418.
- ↑ Schroeder MA, DiPersio JF (2011). "Mouse models of graft-versus-host disease: advances and limitations". Dis Model Mech. 4 (3): 318–33. doi:10.1242/dmm.006668. PMC 3097454. PMID 21558065.
- ↑ 3.0 3.1 Rezvani AR, Storb RF (2012). "Prevention of graft-vs.-host disease". Expert Opin Pharmacother. 13 (12): 1737–50. doi:10.1517/14656566.2012.703652. PMC 3509175. PMID 22770714.
- ↑ Jacobsohn DA, Vogelsang GB (2007). "Acute graft versus host disease". Orphanet J Rare Dis. 2: 35. doi:10.1186/1750-1172-2-35. PMC 2018687. PMID 17784964.