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Related Experiment Videos

1994 Consensus Conference on Acute GVHD Grading

D Przepiorka1, D Weisdorf, P Martin

  • 1University of Texas MD Anderson Cancer Center, Houston 77030, USA.

Bone Marrow Transplantation
|June 1, 1995
PubMed
Summary

Standard acute graft-versus-host disease (GVHD) grading criteria effectively predict mortality and treatment response. Nausea with histologic GVHD, without diarrhea, may be classified as stage 1 gastrointestinal GVHD.

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Area of Science:

  • Hematology
  • Immunology
  • Oncology

Background:

  • Established criteria for grading acute graft-versus-host disease (GVHD) rely on rash, bilirubin, and diarrhea quantification.
  • These standard GVHD grading criteria have been in use for over two decades but lack validation with cyclosporine prophylaxis.

Framework:

  • The 1994 Keystone Consensus Conference reviewed existing GVHD grading criteria using data from 8,249 patients across 12 transplant centers and 2 registries.
  • The conference aimed to assess data supporting revisions and establish recommendations for reporting GVHD prevention trial outcomes.

Implementation:

  • Analysis confirmed that standard GVHD grading criteria effectively differentiate mortality risks and treatment response rates.
  • Inclusion of persistent nausea with histologic evidence of GVHD (without diarrhea) as stage 1 gastrointestinal GVHD was proposed.

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  • Further studies are recommended to address outcome heterogeneity within GVHD grades before implementing revisions.

    • Implications:

    • Recommendations for reporting GVHD prevention trials include specifying the grading system used and reporting corrected actuarial rates for grades II-IV and III-IV GVHD.
    • Improved reporting should incorporate graft failure corrections, early relapse interventions, GVHD therapy indications, and response metrics.
    • Standardized reporting enhances comparability across publications and facilitates accurate assessment of GVHD management strategies.