Systemic Sclerosis after Bone Marrow Transplantation: A Case with Evidence of Donor-related Disease Transfer
Bibliographic record
Abstract
To the Editor: A 34-year-old man was diagnosed in January 2002 with acute B lymphoblastic leukemia. After induction chemotherapy with vincristine and daunorubicin, complete remission was achieved. In October 2011 a bone marrow relapse was detected. He was treated with clofarabine, attaining morphological remission with minimal residual disease, and in February 2012 he received a haplo-identical allogeneic bone marrow transplantation (BMT) from his mother, achieving a second complete remission. Graft versus host disease (GVHD) prophylaxis consisted of cyclophosphamide on days +3 and +4, short-term mycophenolate mofetil, and cyclosporine as maintenance therapy. Complete donor chimerism was seen from Day +30 and has been maintained since. Ninety days after BMT, he developed a maculopapular rash with > 50% of the skin affected, diagnosed as acute GVHD grade II. He required prolonged corticosteroid treatment until clinical resolution. In March 2013 he presented with telangiectasia on his face, forearms, and abdomen, and dry eye and dry mouth that were attributed to chronic GVHD. Only artificial tears were … Address correspondence to Dr. A. Silva Riveiro, Department of Rheumatology, Hospital General Universitario Gregorio Marañón, Calle del Doctor Esquerdo 46, 28009, Madrid, Spain. E-mail: alicia.silvariveiro{at}gmail.com
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.008 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.002 | 0.001 |
| Bibliometrics | 0.002 | 0.002 |
| Science and technology studies | 0.002 | 0.002 |
| Scholarly communication | 0.002 | 0.003 |
| Open science | 0.002 | 0.002 |
| Research integrity | 0.009 | 0.005 |
| Insufficient payload (model declined to judge) | 0.004 | 0.002 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".