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Graft-versus-host Disease

Investigator feedback about the 2005 NIH diagnostic and scoring criteria for chronic GVHD

Bone Marrow Transplantation volume 49, pages 532–538 (2014)Cite this article

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Abstract

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.

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Acknowledgements

We thank all participants in the web survey for their valuable time and opinions. This work was supported by grants CA118953 and CA163438 from the National Institutes of Health (NIH). The Chronic GVHD Consortium (U54 CA163438) is a part of the NIH Rare Diseases Clinical Research Network (RDCRN), supported through collaboration between the NIH Office of Rare Diseases Research (ORDR) at the National Center for Advancing Translational Science (NCATS), the National Cancer Institute, and the Fred Hutchinson Cancer Research Center. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

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Authors and Affiliations

  1. Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA

    Y Inamoto, P A Carpenter, M E D Flowers, P J Martin & S J Lee

  2. Hematology and Stem Cell Transplant Program, Vanderbilt University Medical Center, Nashville, TN, USA

    M Jagasia

  3. Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA

    W A Wood

  4. Blood and Marrow Transplantation, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA

    J Pidala

  5. Division of Hematology/Oncology, Medical College of Wisconsin, Milwaukee, WI, USA

    J Palmer

  6. Division of Hematology/Oncology, Mayo Clinic Arizona, Scottsdale, AZ, USA

    N Khera

  7. Blood and Marrow Transplant Program, University of Minnesota Medical Center, Minneapolis, MN, USA

    D Weisdorf

  8. Division of Blood and Marrow Transplantation, Center for Cancer and Blood Disorders, Children's National Medical Center, Washington, DC, USA

    D Jacobsohn

  9. National Cancer Institute, Bethesda, MD, USA

    S Z Pavletic

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Correspondence to Y Inamoto.

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Inamoto, Y., Jagasia, M., Wood, W. et al. Investigator feedback about the 2005 NIH diagnostic and scoring criteria for chronic GVHD. Bone Marrow Transplant 49, 532–538 (2014). https://doi.org/10.1038/bmt.2013.225

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