1. ¹Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
2. ²Division of Clinical Research, Fred Hutchinson Cancer Research Center, University of Washington School of Medicine, Seattle, WA, USA
3. ³Department of Hematology-Transplantation, AP-HP Hospital Saint Louis, Service d'Hematologie Greffe, Paris, France
4. ⁴The Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, MD, USA

Correspondence: Dr SZ Pavletic, Graft-Versus-Host and Autoimmunity Unit, Experimental Transplantation and Immunology Branch, National Cancer Institute, 9000 Rockville Pike, CRC 3-3330, Bethesda, MD 20892-1203, USA. E-mail: pavletis@mail.nih.gov

Received 2 June 2006; Revised 31 July 2006; Accepted 2 August 2006; Published online 18 September 2006.

Abstract

Chronic graft-versus-host disease (GVHD) has been a difficult problem to address and clinical research in this area lags behind other innovations in hematopoietic stem cell transplantation (HCT). Recently the international transplant community has focused more on chronic GVHD. This new focus is well represented by the development of the National Institutes of Health sponsored chronic GVHD consensus project, which has unified the transplant community's approach to chronic GVHD through the activities of focused working groups. From December 2005 through May 2006, a series of consensus documents have been published addressing the areas of diagnosis and staging, histopathology, strategies for the development and validation of biomarkers, response criteria, ancillary therapy and supportive care and the design of clinical trials. This paper summarizes and discusses these reports, focusing specifically on diagnosis and scoring and response criteria. Although these documents represent a huge effort by the research community, they must be prospectively implemented and validated. These new criteria should advance the standards and uniformity of chronic GVHD clinical research. The ultimate success of this project is dependent on whether these recommendations move the field forward. This is an opportunity for the transplant community to unite and make a significant impact in chronic GVHD.