Toward a Better Understanding of the Atypical Features of Chronic Graft-Versus-Host Disease: A Report from the 2020 National Institutes of Health Consensus Project Task Force

Cuvelier GD, Schoettler M, Buxbaum NP, Pinal-Fernandez I, Schmalzing M, Distler J, Penack O, Santomasso BD, Zeiser R, Angstwurm K, MacDonald KP, Kimberly WT, Taylor N, Bilic E, Banas B, Büttner-Herold M, Sinha N, Greinix HT, Pidala J, Schultz KR, Williams KM, Inamoto Y, Cutler C, Griffith LM, Lee SJ, Sarantopoulos S, Pavletic SZ, Wolff D (2022)

Publication Type: Journal article, Review article

Publication year: 2022

Journal

DOI: 10.1016/j.jtct.2022.05.038

Abstract

Alloreactive and autoimmune responses after allogeneic hematopoietic cell transplantation can occur in nonclassical chronic graft-versus-host disease (chronic GVHD) tissues and organ systems or manifest in atypical ways in classical organs commonly affected by chronic GVHD. The National Institutes of Health (NIH) consensus projects were developed to improve understanding and classification of the clinical features and diagnostic criteria for chronic GVHD. Although still speculative whether atypical manifestations are entirely due to chronic GVHD, these manifestations remain poorly captured by the current NIH consensus project criteria. Examples include chronic GVHD impacting the hematopoietic system as immune mediated cytopenias, endothelial dysfunction, or as atypical features in the musculoskeletal system, central and peripheral nervous system, kidneys, and serous membranes. These purported chronic GVHD features may contribute significantly to patient morbidity and mortality. Most of the atypical chronic GVHD features have received little study, particularly within multi-institutional and prospective studies, limiting our understanding of their frequency, pathogenesis, and relation to chronic GVHD. This NIH consensus project task force report provides an update on what is known and not known about the atypical manifestations of chronic GVHD while outlining a research framework for future studies to be undertaken within the next 3 to 7 years. We also provide provisional diagnostic criteria for each atypical manifestation, along with practical investigation strategies for clinicians managing patients with atypical chronic GVHD features.

Authors with CRIS profile

Involved external institutions

Massachusetts General Hospital United States (USA) (US) National Cancer Institute (NCI) United States (USA) (US) Zagreb University Hospital Centre / Klinički bolnički centar Zagreb (KBC) Croatia (HR) Universitätsklinikum Regensburg Germany (DE) University of Manitoba Canada (CA) Medizinische Universität Graz Austria (AT) H. Lee Moffitt Cancer Center & Research Institute United States (USA) (US) BC Cancer Canada (CA) Children's Healthcare of Atlanta Inc. United States (USA) (US) National Cancer Center Hospital Japan (JP) Dana–Farber Cancer Institute United States (USA) (US) National Institute of Allergy and Infectious Diseases United States (USA) (US) University of Washington United States (USA) (US) Duke University Medical Center United States (USA) (US) Roswell Park Cancer Institute United States (USA) (US) US National Institutes of Health (NIH) United States (USA) (US) Julius-Maximilians-Universität Würzburg Germany (DE) Charité - Universitätsmedizin Berlin Germany (DE) Memorial Sloan Kettering Cancer Center United States (USA) (US) Universitätsklinikum Freiburg Germany (DE) QIMR Berghofer Medical Research Institute (früher: the Queensland Institute of Medical Research) Australia (AU)

How to cite

APA:

Cuvelier, G.D., Schoettler, M., Buxbaum, N.P., Pinal-Fernandez, I., Schmalzing, M., Distler, J.,... Wolff, D. (2022). Toward a Better Understanding of the Atypical Features of Chronic Graft-Versus-Host Disease: A Report from the 2020 National Institutes of Health Consensus Project Task Force. Transplantation and Cellular Therapy. https://doi.org/10.1016/j.jtct.2022.05.038

MLA:

Cuvelier, Geoffrey D.E., et al. "Toward a Better Understanding of the Atypical Features of Chronic Graft-Versus-Host Disease: A Report from the 2020 National Institutes of Health Consensus Project Task Force." Transplantation and Cellular Therapy (2022).

BibTeX: Download