Treatment patterns of extracorporeal photopheresis in steroid-refractory graft versus host disease: A delphi study
Bibliographic record
Abstract
Steroid-refractory GvHD (SR-GvHD) following allogeneic transplant is a major clinical challenge and is associated with substantial mortality [ 1 ]. While the European Society for Bone and Marrow Transplantation (EBMT) recommends ruxolitinib for second-line treatment of GvHD [ 2 ], some patients may experience side effects or refractoriness, and therefore require alternative treatment options [ 2 ]. However, there are no standardized treatment recommendations for SR-GvHD beyond ruxolitinib in Europe [ 2 ]. Extracorporeal photopheresis (ECP), a cell-based, immunomodulatory therapy, is quoted as a potential treatment option beyond second-line, in the EBMT guidelines [ 2 ]. ECP has been shown to be an effective and well-tolerated treatment for SR-GvHD [ 3 ]. Clinical evidence has limitations though, including few randomized studies and a lack of consensus on optimal treatment schedule [ 3 , 4 ]. A Delphi study was thus carried out to provide a descriptive account of clinical practice regarding ECP treatment patterns in SR-GvHD.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
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 teacher head, 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".