Grading and Reporting of Graft-versus-Host Disease in the Modern Era

Graft-versus-host disease (GVHD) continues to be a major cause of morbidity after allogeneic stem cell transplantation. This article summarizes current approaches to grading and reporting gastrointestinal GVHD while outlining key histopathological features, diagnostic thresholds, and interpretive challenges. It emphasizes the need for clinicopathologic correlation and awareness of common mimickers, and the growing role of plasma biomarkers in risk stratification/assessment. Emerging tools in artificial intelligence-enabled digital pathology and standardized reporting practices aim to improve diagnostic accuracy, reproducibility, and clinical relevance in the management of GVHD in modern practice.