Histologic Features of the Liver Biopsy Predict the Clinical Outcome for Patients with Graft-versus-Host Disease of the Liver Rafael F. Duarte, Julio.

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Histologic Features of the Liver Biopsy Predict the Clinical Outcome for Patients with Graft-versus-Host Disease of the Liver Rafael F. Duarte, Julio Delgado, Bronwen E. Shaw, David J. Wrench, Mark Ethell, David Patch, Amar P. Dhillon, Stephen Mackinnon, Mike N. Potter, Alberto F. Quaglia Biology of Blood and Marrow Transplantation Volume 11, Issue 10, Pages 805-813 (October 2005) DOI: 10.1016/j.bbmt.2005.06.008 Copyright © 2005 American Society for Blood and Marrow Transplantation Terms and Conditions

Figure 1 The degrees of lobular inflammation and hepatocyte ballooning in the liver biopsy sample are associated with nonrelapse mortality (NRM) and overall survival (OS) in patients with L-GVHD. A, The NRM in the study population was 68.15% (95% CI, 54.87%-81.43%) at 1 year. B, The median OS was 6.2 months, with a probability of OS at 1 year of 26.48% (95% CI, 15.34%-37.62%). The effect is shown of the degree of lobular inflammation in the first liver biopsy sample (grades 0-1, solid line; grades 2-3, dashed line) in NRM (C) and OS (D). The effect is also shown of the degree of hepatocyte ballooning in the first liver biopsy sample (grades 0-1, solid line; grades 2-3, dashed line) in NRM (E) and OS (F). Crosses mark censored cases. Biology of Blood and Marrow Transplantation 2005 11, 805-813DOI: (10.1016/j.bbmt.2005.06.008) Copyright © 2005 American Society for Blood and Marrow Transplantation Terms and Conditions

Figure 2 Histologic risk associated with the outcome of liver GVHD. Top: Liver biopsy sample from a patient with good histologic risk (see text) as defined by marked grade 3 lobular inflammation, with many lymphocytes infiltrating liver cell plates, and minimal (grade 1) hepatocyte ballooning. Bottom: Liver biopsy sample from a patient with poor histologic risk, as defined by widespread grade 3 hepatocyte ballooning and the absence of lobular inflammation (grade 0). The edge of a portal tract is present in the lower part. Both pictures were taken with an Axiocam camera at ×200 magnification in a Axioskop 2 microscope (Carl Zeiss Ltd., Herts, UK). Axiovision 3.0 software was used for acquisition, and Adobe Photoshop 7.0 was used for image balance correction (stain, hematoxylin and eosin). Biology of Blood and Marrow Transplantation 2005 11, 805-813DOI: (10.1016/j.bbmt.2005.06.008) Copyright © 2005 American Society for Blood and Marrow Transplantation Terms and Conditions