A Single Center Experience of Central Nervous System Manifestations of Graft Versus Host Disease.
Bibliographic record
Abstract
Central nervous system (CNS) involvement of graft versus host disease (GvHD) is a rare cause of CNS disorders after allogeneic hematopoietic stem cell transplantation (Allo-HSCT). CNS GvHD symptoms are heterogeneous and include cerebrovascular manifestations, demyelinating disease and immune-mediated encephalitis. The 2010 consensus conference on GVHD provided a framework to diagnose this syndrome (1) Cases: We report 8 cases of possible CNS-GVHD from our center. Table 1 summarizes key transplant related characteristics while Table 2 summarizes neurological features of the cases. Altered mental status due to encephalopathy was the most common presentation with a lesser incidence of seizure, hemiparesis, altered higher mental functions as well as cerebellar dysfunction. 6 amongst these had histological evidence of immune-mediated pathological process. Only one case could be diagnosed as definite CNS GvHD as per 2010 guidelines while one more could be diagnosed as probable. Out of the 7 cases who were treated with immunosuppression, 4 showed a partial response. Only two of the cases showed long term survival (>1 year) after the onset of CNS-GvHD. CNS-related GvHD is a rare cause of CNS disorders after Allo-HSCT and is associated with a poor prognosis. The diagnosis of CNS-GvHD by the 2010 consensus criteria is based on rigid criteria and does not cover a majority of cases with strong clinical suspicion.
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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 | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 0.001 |
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".