Biology of Blood and Marrow Transplantation
Volume 12, Issue 1 , Pages 31-47, January 2006

Histopathologic Diagnosis of Chronic Graft-versus-Host Disease: National Institutes of Health Consensus Development Project on Criteria for Clinical Trials in Chronic Graft-versus-Host Disease: II. Pathology Working Group Report

  • Howard M. Shulman

      Affiliations

    • Fred Hutchinson Cancer Research Center, University of Washington School of Medicine, Seattle, Washington
    • Corresponding Author InformationCorrespondence and reprint requests: Howard M. Shulman, MD, Fred Hutchinson Cancer Research Center and Seattle Cancer Care Alliance, Department of Pathology, University of Washington, 825 Eastlake Ave. E., Seattle, WA 98109
    • ,
  • David Kleiner

      Affiliations

    • National Cancer Institute, National Institutes of Health, Bethesda, Maryland
    • ,
  • Stephanie J. Lee

      Affiliations

    • Dana-Farber Cancer Institute, Boston, Massachusetts
    • ,
  • Thomas Morton

      Affiliations

    • University of Washington School of Dentistry, Seattle, Washington
    • ,
  • Steven Z. Pavletic

      Affiliations

    • National Cancer Institute, National Institutes of Health, Bethesda, Maryland
    • ,
  • Evan Farmer

      Affiliations

    • Johns Hopkins University School of Medicine, Baltimore, Maryland
    • ,
  • J. Margaret Moresi

      Affiliations

    • Johns Hopkins University School of Medicine, Baltimore, Maryland
    • ,
  • Joel Greenson

      Affiliations

    • University of Michigan Hospitals, Ann Arbor, Michigan
    • ,
  • Anne Janin

      Affiliations

    • Hospital Saint Louis, Paris, France
    • ,
  • Paul J. Martin

      Affiliations

    • Fred Hutchinson Cancer Research Center, University of Washington School of Medicine, Seattle, Washington
    • ,
  • George McDonald

      Affiliations

    • Fred Hutchinson Cancer Research Center, University of Washington School of Medicine, Seattle, Washington
    • ,
  • Mary E.D. Flowers

      Affiliations

    • Fred Hutchinson Cancer Research Center, University of Washington School of Medicine, Seattle, Washington
    • ,
  • Maria Turner

      Affiliations

    • National Cancer Institute, National Institutes of Health, Bethesda, Maryland
    • ,
  • Jane Atkinson

      Affiliations

    • National Institute of Dental and Craniofacial Research, National Institutes of Health, Bethesda, Maryland
    • ,
  • Jay Lefkowitch

      Affiliations

    • Columbia University, New York, New York
    • ,
  • M. Kay Washington

      Affiliations

    • Vanderbilt University, Nashville, Tennessee
    • ,
  • Victor G. Prieto

      Affiliations

    • University of Texas M.D. Anderson Cancer Center, Houston, Texas
    • ,
  • Stella K. Kim

      Affiliations

    • University of Texas M.D. Anderson Cancer Center, Houston, Texas
    • ,
  • Zsolt Argenyi

      Affiliations

    • University of Washington Medical Center, Seattle, Washington
    • ,
  • A. Hafeez Diwan

      Affiliations

    • University of Texas M.D. Anderson Cancer Center, Houston, Texas
    • ,
  • Asif Rashid

      Affiliations

    • University of Texas M.D. Anderson Cancer Center, Houston, Texas
    • ,
  • Kim Hiatt

      Affiliations

    • University of Arkansas for Medical Sciences, Little Rock, Arkansas
    • ,
  • Dan Couriel

      Affiliations

    • University of Texas M.D. Anderson Cancer Center, Houston, Texas
    • ,
  • Kirk Schultz

      Affiliations

    • British Columbia Children’s Hospital, University of British Columbia, Vancouver, British Columbia
    • ,
  • Sharon Hymes

      Affiliations

    • University of Texas M.D. Anderson Cancer Center, Houston, Texas
    • ,
  • Georgia B. Vogelsang

      Affiliations

    • Johns Hopkins University School of Medicine, Baltimore, Maryland

Received 21 October 2005; accepted 24 October 2005.

Abstract 

This consensus document provides an update for pathologists and clinicians about the interpretation of biopsy results and use of this information in the management of hematopoietic cell transplantation patients. Optimal sampling and tissue preparation are discussed. Minimal criteria for the diagnosis of graft-versus-host disease (GVHD) are proposed, together with specific requirements for the diagnosis of chronic GVHD. Four final diagnostic categories (no GVHD, possible GVHD, consistent with GVHD, and definite GVHD) reflect the integration of histopathology with clinical, laboratory, and radiographic information. Finally, the Working Group developed a set of worksheets to facilitate communication of clinical information to the interpreting pathologist and to aid in clinicopathologic correlation studies. Forms are available at http://www.asbmt.org/cGvHD_Guidelines. The recommendations of the Working Group represent a consensus opinion supplemented by evaluation of available peer-reviewed literature. Consensus recommendations and suggested data-capture forms should be validated in prospective clinicopathologic studies.

Key Words:  Chronic graft-versus-host disease , Allogeneic hematopoietic cell transplantation , Consensus diagnosis , Pathology

 

 The opinions expressed here are those of the authors and do not represent the official position of the National Institutes of Health or the US Government.

PII: S1083-8791(05)00722-6

doi:10.1016/j.bbmt.2005.10.023

Biology of Blood and Marrow Transplantation
Volume 12, Issue 1 , Pages 31-47, January 2006

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