Chronic GVHD risk score (CIBMTR)

Prognosis of chronic graft versus host disease

1. Sum the points for each of the following ten risk factors

Risk factor0 points1 point2 points
Age (years)≤ 2930 - 59≥ 60
Prior acute GVHDNonePresent-
Time from trans­plant to cGVHD (months)≥ 5< 5-
Bili­rubin at onset of cGVHD (umol/L)
≤ 34
[≤ 2]
-> 34
[> 2]
Karnof­sky per­formance status at cGVHD onset≥ 80%< 80%-
Plate­let count at cGVHD onset (x109/L)≥ 100< 100-
Donor typeHLA iden­tical sibling, well-matched or partially-matched un­relatedOther related or mis­matched un­related [1]-
Disease status at trans­plant­ation [2]EarlyInter­mediateAd­vanced
Sex mis­match (donor/­recipient)Male/­Male, Female/­Female, Male/­FemaleFemale/­Male-
GVHD prophyl­axisCiclo­sporin +/- metho­trexate +/- otherTacro­limus +/- metho­trexate +/- other, OR T-cell deple­tion-
[1] Well-matched = no defined mismatches and no untested loci; partially-matched = one defined mismatch or untested locus; mismatched = ≥2 known mismatched or untested loci
[2] Early disease = allograft in CR1 (acute leukemia) or first chronic phase (CML) or MDS categories RA or RARS; Intermediate disease = CR2 or later (ALL) or second chronic phase/accelerated phase or later (CML); Advanced disease = patients in relapse or with refractory disease (acute leukemia) or blast crisis (CML) or MDS categories RAEB or RAEB in transformation

2. Use the summed score to determine risk group and prognosis

ScoreRisk group5-year overall survival (%)5-year non-relapse mortality (%)
0 - 21915
3 - 626720
7 - 835033
9 - 1044043
≥ 126472

This prognostic scoring system for chronic graft versus host disease (cGVHD) was published by the Center for International Blood and Marrow Transplant Research (CIBMTR) in 2011.1 It derives from a multivariate analysis of survival of 5343 patients who underwent allogeneic stem cell transplantation from a related or unrelated donor (including umbilical cord blood) for AML, ALL, CML, or MDS between 1995 and 2004, and who were diagnosed with cGVHD within 1 year of transplantation.