Investigator feedback about the 2005 NIH diagnostic and scoring criteria for chronic GVHD.
The 2005 National Institutes of Health (NIH) consensus criteria for chronic GVHD have set standards for reporting. Many questions, however, have arisen regarding their implementation and utilization. To identify perceived areas of controversy, we conducted an international survey on diagnosis and scoring of chronic GVHD. Agreement was observed for 50-83% of the 72 questions in 7 topic areas. There was agreement on the need for modifying criteria in six situations: two or more distinctive manifestations should be enough to diagnose chronic GVHD; symptoms that are not due to chronic GVHD should be scored differently; active disease and fixed deficits should be distinguished; a minimum threshold body surface area of hidebound skin involvement should be required for a skin score of 3; asymptomatic oral lichenoid changes should be considered a score 1; and lung biopsy should be unnecessary to diagnose chronic GVHD in a patient with bronchiolitis obliterans as the only manifestation. The survey also identified 26 points of controversy. Whenever possible, studies should be conducted to confirm the appropriateness of any revisions. In cases where data are not available, clarification of the NIH recommendations by consensus is necessary. This survey should inform future research in the field and revisions of the current consensus criteria.
Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA.
Y
Y
Inamoto
Hematology and Stem Cell Transplant Program, Vanderbilt University Medical Center, Nashville, TN, USA.
M
M
Jagasia
Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
W A
WA
Wood
Blood and Marrow Transplantation, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA.
J
J
Pidala
Division of Hematology/Oncology, Medical College of Wisconsin, Milwaukee, WI, USA.
J
J
Palmer
Division of Hematology/Oncology, Mayo Clinic Arizona, Scottsdale, AZ, USA.
N
N
Khera
Blood and Marrow Transplant Program, University of Minnesota Medical Center, Minneapolis, MN, USA.
D
D
Weisdorf
Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA.
P A
PA
Carpenter
Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA.
M E D
ME
Flowers
Division of Blood and Marrow Transplantation, Center for Cancer and Blood Disorders, Children's National Medical Center, Washington, DC, USA.
D
D
Jacobsohn
Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA.
P J
PJ
Martin
Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA.
S J
SJ
Lee
National Cancer Institute, Bethesda, MD, USA.
S Z
SZ
Pavletic
D002908:Chronic Disease; D003625:Data Collection; D006086:Graft vs Host Disease / Q000175:diagnosis* / Q000473:pathology; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects / Q000379:methods; D006801:Humans; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D019172:Transplantation Conditioning / Q000379:methods; D014184:Transplantation, Homologous; D014481:United States