Histopathologic diagnosis of chronic graft-versus-host disease: National Institutes of Health Consensus Development Project on Criteria for Clinical Trials in Chronic Graft-versus-Host Disease: II. Pathology Working Group Report.
This consensus document provides an update for pathologists and clinicians about the interpretation of biopsy results and use of this information in the management of hematopoietic cell transplantation patients. Optimal sampling and tissue preparation are discussed. Minimal criteria for the diagnosis of graft-versus-host disease (GVHD) are proposed, together with specific requirements for the diagnosis of chronic GVHD. Four final diagnostic categories (no GVHD, possible GVHD, consistent with GVHD, and definite GVHD) reflect the integration of histopathology with clinical, laboratory, and radiographic information. Finally, the Working Group developed a set of worksheets to facilitate communication of clinical information to the interpreting pathologist and to aid in clinicopathologic correlation studies. Forms are available at . The recommendations of the Working Group represent a consensus opinion supplemented by evaluation of available peer-reviewed literature. Consensus recommendations and suggested data-capture forms should be validated in prospective clinicopathologic studies.
Shulman
Howard M
HM
Department of Pathology, Fred Hutchinson Cancer Research Center, Seattle Cancer Care Alliance, University of Washington School of Medicine, Seattle, Washington 98109, USA. hshulman@seattlecca.org
Kleiner
David
D
Lee
Stephanie J
SJ
Morton
Thomas
T
Pavletic
Steven Z
SZ
Farmer
Evan
E
Moresi
J Margaret
JM
Greenson
Joel
J
Janin
Anne
A
Martin
Paul J
PJ
McDonald
George
G
Flowers
Mary E D
ME
Turner
Maria
M
Atkinson
Jane
J
Lefkowitch
Jay
J
Washington
M Kay
MK
Prieto
Victor G
VG
Kim
Stella K
SK
Argenyi
Zsolt
Z
Diwan
A Hafeez
AH
Rashid
Asif
A
Hiatt
Kim
K
Couriel
Dan
D
Schultz
Kirk
K
Hymes
Sharon
S
Vogelsang
Georgia B
GB
D001706:Biopsy; D002908:Chronic Disease; D002986:Clinical Trials as Topic / Q000592:standards*; D019468:Disease Management; D006086:Graft vs Host Disease / Q000175:diagnosis / Q000473:pathology*; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects*; D006801:Humans; D009316:National Institutes of Health (U.S.); D010336:Pathology / Q000592:standards; D017410:Practice Guidelines as Topic; D014481:United States