Measuring Therapeutic Response in Chronic Graft-versus-host-disease: National Institutes of Health Consensus Development Project on Criteria for Clinical Trials in Chronic Graft-versus- Host Disease: Iv. Response Criteria Working Group Report

In 2005, the National Institutes of Health (NIH) Chronic Graft-versus-Host Disease (GVHD) Consensus Response Criteria Working Group recommended several measures to document serial evaluations of chronic GVHD organ involvement. Provisional definitions of complete response, partial response, and progression were proposed for each organ and for overall outcome. Based on publications over the last 9 years, the 2014 Working Group has updated its recommendations for measures and interpretation of organ and overall responses. Major changes include elimination of several clinical parameters from the determination of response, updates to or addition of new organ scales to assess response, and the recognition that progression excludes minimal, clinically insignificant worsening that does not usually warrant a change in therapy. The response definitions have been revised to reflect these changes and are expected to enhance reliability and practical utility of these measures in clinical trials. Clarification is provided about response assessment after the addition of topical or organ-targeted treatment. Ancillary measures are strongly encouraged in clinical trials. Areas suggested for additional research include criteria to identify irreversible organ damage and validation of the modified response criteria, including in the pediatric population.

[1]  S. Mineishi,et al.  Bronchiolitis obliterans syndrome (BOS), bronchiolitis obliterans organizing pneumonia (BOOP), and other late-onset noninfectious pulmonary complications following allogeneic hematopoietic stem cell transplantation. , 2007, Biology of blood and marrow transplantation : journal of the American Society for Blood and Marrow Transplantation.

[2]  V. Mathiowetz,et al.  Grip and pinch strength: norms for 6- to 19-year-olds. , 1986, The American journal of occupational therapy : official publication of the American Occupational Therapy Association.

[3]  S. Sonis,et al.  Antimicrobial therapy to prevent or treat oral mucositis. , 2003, The Lancet. Infectious diseases.

[4]  P. Campregher,et al.  Lung function and long-term complications after allogeneic hematopoietic cell transplant. , 2010, Biology of blood and marrow transplantation : journal of the American Society for Blood and Marrow Transplantation.

[5]  S. Elad,et al.  A randomized controlled trial of visible-light therapy for the prevention of oral mucositis. , 2011, Oral oncology.

[6]  M. Turner,et al.  National Institutes of Health consensus development project on criteria for clinical trials in chronic graft-versus-host disease: I. Diagnosis and staging working group report. , 2005, Biology of blood and marrow transplantation : journal of the American Society for Blood and Marrow Transplantation.

[7]  Y. Jen,et al.  Phenylbutyrate mouthwash mitigates oral mucositis during radiotherapy or chemoradiotherapy in patients with head-and-neck cancer. , 2012, International Journal of Radiation Oncology, Biology, Physics.

[8]  B. Mohanti,et al.  Lactobacillus brevis CD2 lozenges reduce radiation- and chemotherapy-induced mucositis in patients with head and neck cancer: a randomized double-blind placebo-controlled study. , 2012, European journal of cancer.

[9]  J. Wright,et al.  Measurement properties of the activities scale for kids. , 2000, Journal of clinical epidemiology.

[10]  M. Nagashima,et al.  The ability of disease modifying antirheumatic drugs to induce and maintain improvement in patients with rheumatoid arthritis. epidemiology of DMARDs treatment in Japan. , 2005, Clinical and experimental rheumatology.

[11]  C. Barber,et al.  Comparing pain control and ability to eat and drink with standard therapy vs Gelclair: a preliminary, double centre, randomised controlled trial on patients with radiotherapy-induced oral mucositis , 2007, Supportive Care in Cancer.

[12]  C. Cleeland,et al.  Assessing symptom distress in cancer patients: the M.D. Anderson Symptom Inventory. , 2000, Cancer.

[13]  H. Deeg,et al.  Therapy for chronic graft-versus-host disease: a randomized trial comparing cyclosporine plus prednisone versus prednisone alone. , 2002, Blood.

[14]  M. Vidyasagar,et al.  Effect of low-level laser therapy on patient reported measures of oral mucositis and quality of life in head and neck cancer patients receiving chemoradiotherapy—a randomized controlled trial , 2013, Supportive Care in Cancer.

[15]  L. Matza,et al.  Assessment of health-related quality of life in children: a review of conceptual, methodological, and regulatory issues. , 2004, Value in health : the journal of the International Society for Pharmacoeconomics and Outcomes Research.

[16]  J. Epstein,et al.  Doxepin rinse for management of mucositis pain in patients with cancer: one week follow-up of topical therapy. , 2008, Special care in dentistry : official publication of the American Association of Hospital Dentists, the Academy of Dentistry for the Handicapped, and the American Society for Geriatric Dentistry.

[17]  S. Piantadosi,et al.  Development of a prognostic model for grading chronic graft-versus-host disease. , 2001, Blood.

[18]  Li Li,et al.  A multicenter pilot evaluation of the National Institutes of Health chronic graft-versus-host disease (cGVHD) therapeutic response measures: feasibility, interrater reliability, and minimum detectable change. , 2011, Biology of blood and marrow transplantation : journal of the American Society for Blood and Marrow Transplantation.

[19]  P. Opolon,et al.  Differential effect triggered by a heparan mimetic of the RGTA family preventing oral mucositis without tumor protection. , 2009, International journal of radiation oncology, biology, physics.

[20]  M. Andrykowski,et al.  Psychometric evaluation of the Pittsburgh Sleep Quality Index. , 1998, Journal of psychosomatic research.

[21]  Jan-Jakob Sonke,et al.  Clinical results of image-guided deep inspiration breath hold breast irradiation. , 2010, International journal of radiation oncology, biology, physics.

[22]  John P Klein,et al.  Severity of chronic graft-versus-host disease: association with treatment-related mortality and relapse. , 2002, Blood.

[23]  Lisa I. Wang,et al.  A pilot randomized controlled trial of an oral care intervention to reduce mucositis severity in stem cell transplant patients. , 2012, Journal of pain and symptom management.

[24]  M. List,et al.  The measurement of performance in childhood cancer patients , 1987, Cancer.

[25]  B. Storer,et al.  Clinical benefit of response in chronic graft-versus-host disease. , 2012, Biology of blood and marrow transplantation : journal of the American Society for Blood and Marrow Transplantation.

[26]  B. Kurland,et al.  Validation of measurement scales in ocular graft-versus-host disease. , 2012, Ophthalmology.

[27]  V. Falanga,et al.  Use of a durometer to assess skin hardness. , 1993, Journal of the American Academy of Dermatology.

[28]  A. Huscher,et al.  Transdermal buprenorphine for oropharyngeal mucositis-associated pain in patients treated with radiotherapy for head and neck cancer. , 2010, Journal of palliative medicine.

[29]  A. Bonomi,et al.  Quality of life measurement in bone marrow transplantation: development of the Functional Assessment of Cancer Therapy-Bone Marrow Transplant (FACT-BMT) scale , 1997, Bone Marrow Transplantation.

[30]  J. Varni,et al.  Health-related quality of life in pediatric patients after allogeneic SCT: development of the PedsQL Stem Cell Transplant module and results of a pilot study , 2014, Bone Marrow Transplantation.

[31]  G. Browman,et al.  Prophylaxis of oral mucositis in irradiated head-and-neck cancer patients: a proposed classification scheme of interventions and meta-analysis of randomized controlled trials. , 2001, International journal of radiation oncology, biology, physics.

[32]  J. Pidala,et al.  Hand grip strength and 2-minute walk test in chronic graft-versus-host disease assessment: analysis from the Chronic GVHD Consortium. , 2013, Biology of blood and marrow transplantation : journal of the American Society for Blood and Marrow Transplantation.

[33]  J J Anderson,et al.  American College of Rheumatology. Preliminary definition of improvement in rheumatoid arthritis. , 1995, Arthritis and rheumatism.

[34]  B. Kurland,et al.  Patient-reported quality of life is associated with severity of chronic graft-versus-host disease as measured by NIH criteria: report on baseline data from the Chronic GVHD Consortium. , 2011, Blood.

[35]  P. Lachenbruch,et al.  Defining Clinical Improvement in Adult and Juvenile Myositis. , 2003, The Journal of rheumatology.

[36]  T. Braun,et al.  Soluble tumor necrosis factor receptor: enbrel (etanercept) for subacute pulmonary dysfunction following allogeneic stem cell transplantation. , 2012, Biology of blood and marrow transplantation : journal of the American Society for Blood and Marrow Transplantation.

[37]  Ingela Wiklund,et al.  Assessment of patient‐reported outcomes in clinical trials: the example of health‐related quality of life , 2004, Fundamental & clinical pharmacology.

[38]  K. Stevenson,et al.  Oral chronic graft-versus-host disease scoring using the NIH consensus criteria. , 2009, Biology of blood and marrow transplantation : journal of the American Society for Blood and Marrow Transplantation.

[39]  G. Norman,et al.  Is it simple or simplistic? , 2003, Medical care.

[40]  N. Facione,et al.  Radiation-Induced Mucositis: A Randomized Clinical Trial of Micronized Sucralfate Versus Salt & Soda Mouthwashes , 2003, Cancer investigation.

[41]  A. Bacigalupo,et al.  Female genital tract graft-versus-host disease following allogeneic bone marrow transplantation. , 2003, Haematologica.

[42]  B. Storer,et al.  Association between acute and chronic graft-versus-host disease and bronchiolitis obliterans organizing pneumonia in recipients of hematopoietic stem cell transplants. , 2003, Blood.

[43]  A. Lammers,et al.  The 6-minute walk test: normal values for children of 4–11 years of age , 2007, Archives of Disease in Childhood.

[44]  M. Levitt,et al.  Improvement in oral chronic graft-versus-host disease with the administration of effervescent tablets of topical budesonide-an open, randomized, multicenter study. , 2012, Biology of blood and marrow transplantation : journal of the American Society for Blood and Marrow Transplantation.

[45]  A. Brugnera,et al.  Use of 660-nm diode laser in the prevention and treatment of human oral mucositis induced by radiotherapy and chemotherapy. , 2010, Photomedicine and laser surgery.

[46]  V. Darcourt,et al.  Low-energy He/Ne laser in the prevention of radiation-induced mucositis , 1999, Supportive Care in Cancer.

[47]  C. Sherbourne,et al.  The MOS 36-Item Short-Form Health Survey (SF-36) , 1992 .

[48]  D. Brooks,et al.  The two-minute walk test as a measure of functional capacity in cardiac surgery patients. , 2004, Archives of physical medicine and rehabilitation.

[49]  P. Herzberg,et al.  Personality influences quality-of-life assessments in adult patients after allogeneic hematopoietic SCT: results from a joint evaluation of the prospective German Multicenter Validation Trial and the Fred Hutchinson Cancer Research Center , 2013, Bone Marrow Transplantation.

[50]  D. Kleiner,et al.  Salivary gland involvement in chronic graft-versus-host disease: prevalence, clinical significance, and recommendations for evaluation. , 2010, Biology of blood and marrow transplantation : journal of the American Society for Blood and Marrow Transplantation.

[51]  D. Sackett,et al.  Derivation of the SLEDAI. A disease activity index for lupus patients. The Committee on Prognosis Studies in SLE. , 1992, Arthritis and rheumatism.

[52]  S. Clarke,et al.  Palifermin reduces the incidence of oral mucositis in patients with metastatic colorectal cancer treated with fluorouracil-based chemotherapy. , 2006, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[53]  R. Fanin,et al.  Treatment of refractory chronic GVHD with rituximab: a GITMO study , 2007, Bone Marrow Transplantation.

[54]  C. Bombardier,et al.  The role of children in reporting their physical disability. , 1995, Archives of physical medicine and rehabilitation.

[55]  J. Epstein,et al.  Oral topical doxepin rinse: analgesic effect in patients with oral mucosal pain due to cancer or cancer therapy. , 2001, Oral oncology.

[56]  C. Doré,et al.  Reliability, repeatability and sensitivity to change of externally and self-paced walking tests in COPD patients. , 2003, Respiratory medicine.

[57]  W. Bailey,et al.  Effects of Smoking Intervention and the Use of an Inhaled Anticholinergic Bronchodilator on the Rate of Decline of FEV1 , 1994 .

[58]  G. Baker,et al.  A randomised controlled trial comparing rehabilitation against standard therapy in multiple sclerosis patients receiving intravenous steroid treatment , 2003, Journal of neurology, neurosurgery, and psychiatry.

[59]  P. Stratton,et al.  Female long-term survivors after allogeneic hematopoietic stem cell transplantation: evaluation and management. , 2012, Seminars in hematology.

[60]  D. Au,et al.  Pretransplant lung function, respiratory failure, and mortality after stem cell transplantation. , 2005, American journal of respiratory and critical care medicine.

[61]  R. Schiffman,et al.  Reliability and validity of the Ocular Surface Disease Index. , 2000, Archives of ophthalmology.

[62]  M. Petri,et al.  A phase III, randomized, placebo-controlled study of belimumab, a monoclonal antibody that inhibits B lymphocyte stimulator, in patients with systemic lupus erythematosus. , 2011, Arthritis and rheumatism.

[63]  L. Chow,et al.  Rhodiola algida improves chemotherapy-induced oral mucositis in breast cancer patients , 2010, Expert opinion on investigational drugs.

[64]  J. V. Stone,et al.  Long-term survival and late deaths after allogeneic bone marrow transplantation. Late Effects Working Committee of the International Bone Marrow Transplant Registry. , 1999, The New England journal of medicine.

[65]  John E. Ware,et al.  SF-36 Health Survey Update , 2000, Spine.

[66]  R. Portenoy,et al.  Breakthrough cancer pain: a randomized trial comparing oral transmucosal fentanyl citrate (OTFC®) and morphine sulfate immediate release (MSIR®) , 2001, Pain.

[67]  W. Hauck,et al.  Randomized clinical trial of chlorhexidine versus placebo for prevention of oral mucositis in patients receiving chemotherapy. , 1996, Oncology nursing forum.

[68]  J. Varni,et al.  The PedsQL: measurement model for the pediatric quality of life inventory. , 1999, Medical care.

[69]  M. Paesmans,et al.  The use of low-energy laser (LEL) for the prevention of chemotherapy- and/or radiotherapy-induced oral mucositis in cancer patients: results from two prospective studies , 2008, Supportive Care in Cancer.

[70]  S. Steinberg,et al.  Validation of the National Institutes of Health chronic GVHD Oral Mucosal Score using component-specific measures , 2014, Bone Marrow Transplantation.

[71]  J. Brazier,et al.  What is the relationship between the minimally important difference and health state utility values? The case of the SF-6D , 2003, Health and quality of life outcomes.

[72]  F. V. D. van den Hoogen,et al.  Reliability of two methods to assess morphea: skin scoring and the use of a durometer. , 1997, Journal of the American Academy of Dermatology.

[73]  D. Gossot,et al.  The Spectrum of Lung Involvement in Collagen Vascular-Like Diseases Following Allogeneic Hematopoietic Stem Cell Transplantation: Report of 6 Cases and Review of the Literature , 2011, Medicine.

[74]  Rabia S. Atayee,et al.  Ketamine mouthwash for mucositis pain. , 2009, Journal of palliative medicine.

[75]  D. Osoba,et al.  Interpreting the significance of changes in health-related quality-of-life scores. , 1998, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[76]  N. Leidy,et al.  Incorporating the patient's perspective into drug development and communication: an ad hoc task force report of the Patient-Reported Outcomes (PRO) Harmonization Group meeting at the Food and Drug Administration, February 16, 2001. , 2003, Value in health : the journal of the International Society for Pharmacoeconomics and Outcomes Research.

[77]  S. Steinberg,et al.  NIH response criteria measures are associated with important parameters of disease severity in patients with chronic GVHD , 2014, Bone Marrow Transplantation.

[78]  J. Stockman,et al.  Single-Dose Palifermin Prevents Severe Oral Mucositis During Multicycle Chemotherapy in Patients With Cancer: A Randomized Trial , 2012 .

[79]  A. Scherlacher,et al.  [Radiotherapy of head-neck neoplasms: prevention of inflammation of the mucosa by sucralfate treatment]. , 1990, HNO.

[80]  D. Weisdorf,et al.  Influence of T-cell depletion on chronic graft-versus-host disease: results of a multicenter randomized trial in unrelated marrow donor transplantation. , 2005, Blood.

[81]  C. Cleeland,et al.  Assessing symptom distress in cancer patients , 2000 .

[82]  J. Bijlsma,et al.  The Systemic Lupus Erythematosus Responder Index (SRI); a new SLE disease activity assessment. , 2012, Autoimmunity reviews.

[83]  N. Bae,et al.  Effectiveness of transdermal fentanyl patch for treatment of acute pain due to oral mucositis in patients receiving stem cell transplantation. , 2005, Transplantation proceedings.

[84]  I. Barofsky,et al.  Recommendations on health-related quality of life research to support labeling and promotional claims in the United States , 2004, Quality of Life Research.

[85]  V. Mathiowetz,et al.  Grip and pinch strength: normative data for adults. , 1985, Archives of physical medicine and rehabilitation.

[86]  D. Jacobsohn,et al.  Weight loss and malnutrition in patients with chronic graft-versus-host disease , 2002, Bone Marrow Transplantation.

[87]  J. Lai,et al.  Child and parent perspectives of the chronic graft-versus-host disease (cGVHD) symptom experience: a concept elicitation study , 2014, Supportive Care in Cancer.

[88]  D. Maloney,et al.  A prospective, randomized study of cryotherapy during administration of high-dose melphalan to decrease the severity and duration of oral mucositis in patients with multiple myeloma undergoing autologous peripheral blood stem cell transplantation , 2006, Bone Marrow Transplantation.

[89]  I. Braverman,et al.  Reproducible measurements to quantify cutaneous involvement in scleroderma. , 1995, Archives of dermatology.

[90]  S. Pavletic,et al.  Oral chronic graft-versus-host disease: current pathogenesis, therapy, and research. , 2013, Oral diseases.

[91]  G. Vogelsang,et al.  Chronic graft versus host disease , 2004, British journal of haematology.

[92]  T. Therneau,et al.  Inhibition of fluorouracil-induced stomatitis by oral cryotherapy. , 1991, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[93]  B. Kurland,et al.  Correlation between NIH composite skin score, patient-reported skin score, and outcome: results from the Chronic GVHD Consortium. , 2012, Blood.

[94]  N. Young,et al.  Activities Scale for Kids: An Analysis of Normals , 2003, Journal of pediatric orthopedics.

[95]  J J Anderson,et al.  Ankylosing spondylitis assessment group preliminary definition of short-term improvement in ankylosing spondylitis. , 2001, Arthritis and rheumatism.

[96]  Q. Le,et al.  Palifermin reduces severe mucositis in definitive chemoradiotherapy of locally advanced head and neck cancer: a randomized, placebo-controlled study. , 2011, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[97]  R. Waters,et al.  Energy‐speed relationship of walking: Standard tables , 1988, Journal of orthopaedic research : official publication of the Orthopaedic Research Society.

[98]  G. Donaldson,et al.  Clinical assessment scale for the rating of oral mucosal changes associated with bone marrow transplantation development of an oral mucositis index , 1992, Cancer.

[99]  J. Shelhamer,et al.  National Institutes of Health chronic graft-versus-host disease staging in severely affected patients: organ and global scoring correlate with established indicators of disease severity and prognosis. , 2013, Biology of blood and marrow transplantation : journal of the American Society for Blood and Marrow Transplantation.

[100]  M. Liang,et al.  Reliability and validity of six systems for the clinical assessment of disease activity in systemic lupus erythematosus. , 1989, Arthritis and rheumatism.

[101]  W. Wood,et al.  Pulmonary symptoms measured by the national institutes of health lung score predict overall survival, nonrelapse mortality, and patient-reported outcomes in chronic graft-versus-host disease. , 2014, Biology of blood and marrow transplantation : journal of the American Society for Blood and Marrow Transplantation.

[102]  N. Leidy,et al.  Determinants of functional performance in long-term survivors of allogeneic hematopoietic stem cell transplantation with chronic graft-versus-host disease (cGVHD) , 2010, Bone Marrow Transplantation.

[103]  H. So,et al.  The six-minute walk test in healthy children: reliability and validity , 2005, European Respiratory Journal.

[104]  N. Chu Effect of levodopa treatment for parkinsonism in welders: A double-blind study , 2004, Neurology.

[105]  R. Storb,et al.  Duration of immunosuppressive treatment for chronic graft-versus-host disease. , 2004, Blood.

[106]  J. Atkinson,et al.  Chronic graft versus host disease of oral mucosa: review of available therapies. , 2006, Oral surgery, oral medicine, oral pathology, oral radiology, and endodontics.

[107]  A. Bron,et al.  Grading Of Corneal and Conjunctival Staining in the Context of Other Dry Eye Tests , 2003, Cornea.

[108]  G. Norman,et al.  Interpretation of Changes in Health-related Quality of Life: The Remarkable Universality of Half a Standard Deviation , 2003, Medical care.

[109]  G. Birgegard,et al.  Oral cryotherapy reduces mucositis and opioid use after myeloablative therapy—a randomized controlled trial , 2007, Supportive Care in Cancer.

[110]  A. Eckardt,et al.  Severe oral chronic graft-versus-host disease following allogeneic bone marrow transplantation: highly effective treatment with topical tacrolimus. , 2004, Oral oncology.

[111]  S. Kaplan,et al.  Preliminary psychometric evaluation of the Child Health Ratings Inventory (CHRIs) and Disease-Specific Impairment Inventory-Hematopoietic Stem Cell Transplantation (DSII-HSCT) in parents and children , 2005, Quality of Life Research.

[112]  E. Cook,et al.  Development and validation of a scale to measure symptoms of chronic graft-versus-host disease. , 2002, Biology of blood and marrow transplantation : journal of the American Society for Blood and Marrow Transplantation.

[113]  C. Kalofonos,et al.  Prevention of 5-fluorouracil-related stomatitis by oral cryotherapy: a randomized controlled study. , 2007, European journal of oncology nursing : the official journal of European Oncology Nursing Society.

[114]  F. Spijkervet,et al.  Effect of selective elimination of the oral flora on mucositis in irradiated head and neck cancer patients , 1991, Journal of surgical oncology.

[115]  A. Sevinç,et al.  Evaluation of the effect of cryotherapy in preventing oral mucositis associated with chemotherapy - a randomized controlled trial. , 2012, European journal of oncology nursing : the official journal of European Oncology Nursing Society.

[116]  G. Slade Assessing change in quality of life using the Oral Health Impact Profile. , 1998, Community dentistry and oral epidemiology.

[117]  E. Farmer,et al.  Oral PUVA and topical steroids for treatment of oral manifestations of chronic graft‐vs.‐host disease , 2004, Photodermatology, photoimmunology & photomedicine.

[118]  S. Kaplan,et al.  Health‐related quality of life in pediatric bone marrow transplant survivors: According to whom? , 1999, International journal of cancer. Supplement = Journal international du cancer. Supplement.

[119]  L. Cerezo,et al.  Palifermin decreases severe oral mucositis of patients undergoing postoperative radiochemotherapy for head and neck cancer: a randomized, placebo-controlled trial. , 2011, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[120]  M. Vidyasagar,et al.  Low level laser therapy for concurrent chemoradiotherapy induced oral mucositis in head and neck cancer patients - a triple blinded randomized controlled trial. , 2012, Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology.

[121]  S. Svegliati,et al.  Long-term outcome and prospective validation of NIH response criteria in 39 patients receiving imatinib for steroid-refractory chronic GVHD. , 2013, Blood.

[122]  J. Atkinson,et al.  Salivary hypofunction and xerostomia: diagnosis and treatment. , 2005, Dental clinics of North America.

[123]  M. Denniston,et al.  Measurement of fatigue in cancer patients: Further validation of the Fatigue Symptom Inventory , 2004, Quality of Life Research.

[124]  A. Ghavamzadeh,et al.  Effect of pilocarpine hydrochloride on unstimulated whole saliva flow rate and composition in patients with chronic graft-versus-host disease (cGVHD) , 2007, Bone Marrow Transplantation.

[125]  M. Ward,et al.  Comparison of the validity and sensitivity to change of 5 activity indices in systemic lupus erythematosus. , 2000, The Journal of rheumatology.

[126]  R. Childs,et al.  Topical thalidomide gel in oral chronic GVHD and role of in situ cytokine expression in monitoring biological activity , 2013, Bone Marrow Transplantation.

[127]  S. Elad,et al.  Validation of the National Institutes of Health (NIH) scale for oral chronic graft-versus-host disease (cGVHD). , 2010, Biology of blood and marrow transplantation : journal of the American Society for Blood and Marrow Transplantation.

[128]  D. Brizel,et al.  Phase II study of palifermin and concurrent chemoradiation in head and neck squamous cell carcinoma. , 2008, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[129]  D. Cowen,et al.  Low energy Helium-Neon laser in the prevention of oral mucositis in patients undergoing bone marrow transplant: results of a double blind randomized trial. , 1997, International journal of radiation oncology, biology, physics.

[130]  K. Dumford,et al.  CT and MRI findings in sclerodermatous chronic graft vs. host disease. , 2001, Clinical imaging.

[131]  Daniel J Buysse,et al.  The Pittsburgh sleep quality index: A new instrument for psychiatric practice and research , 1989, Psychiatry Research.

[132]  M. Turner,et al.  Vulvovaginal Chronic Graft-Versus-Host Disease With Allogeneic Hematopoietic Stem Cell Transplantation , 2007, Obstetrics and gynecology.

[133]  L. Nail,et al.  Operationalizing symptom distress in adults with cancer: a literature synthesis. , 2005, Oncology nursing forum.

[134]  K. Ohrn,et al.  Oral cryotherapy reduces mucositis and improves nutrition - a randomised controlled trial. , 2010, Journal of clinical nursing.

[135]  P. Rutgeerts,et al.  A review of activity indices and efficacy endpoints for clinical trials of medical therapy in adults with Crohn's disease. , 2002, Gastroenterology.

[136]  C. Basch,et al.  Pediatric allo-SCT for malignant and non-malignant diseases: impact on health-related quality of life outcomes , 2013, Bone Marrow Transplantation.

[137]  A. Balan,et al.  Effectiveness of triclosan in the management of radiation-induced oral mucositis: a randomized clinical trial. , 2010, Journal of cancer research and therapeutics.

[138]  J. Clayton,et al.  International Chronic Ocular Graft-vs-Host-Disease (GVHD) Consensus Group: Proposed Diagnostic Criteria for Chronic GVHD (Part I) , 2013, Scientific Reports.

[139]  B. Reeve,et al.  Feasibility and Reproducibility of the New NIH Consensus Criteria To Evaluate Response in Chronic GvHD - A Pilot Study. , 2005 .

[140]  R. Jonsson,et al.  Classification criteria for Sjögren's syndrome: a revised version of the European criteria proposed by the American-European Consensus Group , 2002, Annals of the rheumatic diseases.

[141]  P. Herzberg,et al.  Validation of the grip test and human activity profile for evaluation of physical performance during the intermediate phase after allogeneic hematopoietic stem cell transplantation , 2013, Supportive Care in Cancer.

[142]  H. Greinix,et al.  A single-center pilot validation study of a new chronic GVHD skin scoring system. , 2007, Biology of blood and marrow transplantation : journal of the American Society for Blood and Marrow Transplantation.

[143]  A. Barrett,et al.  Topical corticosteroid therapy for cicatricial conjunctivitis associated with chronic graft-versus-host disease , 2004, Bone Marrow Transplantation.

[144]  J. Klein,et al.  Risk factors associated with increased nonrelapse mortality and with poor overall survival in children with chronic graft-versus-host disease. , 2011, Blood.

[145]  B. Sandmaier,et al.  Failure-free survival after second-line systemic treatment of chronic graft-versus-host disease. , 2013, Blood.

[146]  P. Herzberg,et al.  Validation of the human activity profile questionnaire in patients after allogeneic hematopoietic stem cell transplantation. , 2010, Biology of blood and marrow transplantation : journal of the American Society for Blood and Marrow Transplantation.

[147]  A. Colman,et al.  Optimal number of response categories in rating scales: reliability, validity, discriminating power, and respondent preferences. , 2000, Acta psychologica.

[148]  P. Robertson,et al.  Absorption of Fentanyl from Fentanyl Buccal Tablet in Cancer Patients With or Without Oral Mucositis , 2007, Clinical drug investigation.

[149]  M. Kerscher,et al.  Chronic cutaneous sclerodermoid graft‐versus‐host disease: evaluation by 20‐MHz sonography , 2003, Journal of the European Academy of Dermatology and Venereology : JEADV.

[150]  A. Borkhardt,et al.  Oral graft vs. host disease in children – Treatment with topical tacrolimus ointment , 2007, Pediatric transplantation.

[151]  R. Seshadri,et al.  EOSINOPHILIA CORRELATES WITH THE PRESENCE OR DEVELOPMENT OF CHRONIC GRAFT-VERSUS-HOST DISEASE IN CHILDREN , 2004, Transplantation.

[152]  S. Farag Chronic graft-versus-host disease: where do we go from here? , 2004, Bone Marrow Transplantation.

[153]  W. Bailey,et al.  Smoking cessation and lung function in mild-to-moderate chronic obstructive pulmonary disease. The Lung Health Study. , 2000, American journal of respiratory and critical care medicine.

[154]  S. Kaplan,et al.  Maternal perspectives on children's health-related quality of life during the first year after pediatric hematopoietic stem cell transplant. , 2006, Journal of pediatric psychology.

[155]  M. Vidyasagar,et al.  Efficacy of He-Ne Laser in the prevention and treatment of radiotherapy-induced oral mucositis in oral cancer patients. , 2008, Oral surgery, oral medicine, oral pathology, oral radiology, and endodontics.

[156]  J. Giordano,et al.  Use of sublingual methadone for treating pain of chemotherapy-induced oral mucositis. , 2010, Journal of opioid management.

[157]  A. Loeckinger,et al.  Six-minute walk test in children and adolescents. , 2007, The Journal of pediatrics.

[158]  S. Lopez,et al.  Efficacy of gelclair in reducing pain in palliative care patients with oral lesions: preliminary findings from an open pilot study. , 2002, Journal of pain and symptom management.

[159]  V. Mathiowetz,et al.  Reliability and validity of grip and pinch strength evaluations. , 1984, The Journal of hand surgery.

[160]  David T Felson,et al.  UvA-DARE (Digital Academic Repository) American College of Rheumatology/European League against Rheumatism provisional definition of remission in rheumatoid arthritis for clinical trials , 2011 .

[161]  D. Madtes,et al.  Pulmonary function testing prior to hematopoietic stem cell transplantation , 2005, Bone Marrow Transplantation.

[162]  S. Steinberg,et al.  Oral Chronic Graft-vs.-Host Disease Characterization Using the NIH Scale , 2012, Journal of dental research.

[163]  Steven Hirschfeld,et al.  Measuring Therapeutic Response in Chronic Graft-versus-Host Disease: National Institutes of Health Consensus Development Project on Criteria for Clinical Trials in Chronic Graft-versus-Host Disease: IV. Response Criteria Working Group Report , 2006 .

[164]  L. Cerchietti,et al.  Effect of topical morphine for mucositis‐associated pain following concomitant chemoradiotherapy for head and neck carcinoma , 2002, Cancer.

[165]  Shao-xiong Wu,et al.  A prospective, randomized, multi-center trial to investigate Actovegin in prevention and treatment of acute oral mucositis caused by chemoradiotherapy for nasopharyngeal carcinoma. , 2010, Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology.

[166]  J. Sørensen,et al.  Double‐blind, placebo‐controlled, randomized study of chlorhexidine prophylaxis for 5‐fluorouracil‐based chemotherapy‐induced oral mucositis with nonblinded randomized comparison to oral cooling (cryotherapy) in gastrointestinal malignancies , 2008, Cancer.

[167]  M. Levenstein,et al.  Efficacy and safety of fluconazole prophylaxis for fungal infections after marrow transplantation--a prospective, randomized, double-blind study. , 1995, The Journal of infectious diseases.