Department of Internal Medicine I, Bone Marrow Transplantation, Medical University of Vienna, Vienna, Austria.
Biol Blood Marrow Transplant. 2011 Feb;17(2):167-75. doi: 10.1016/j.bbmt.2010.07.017. Epub 2010 Aug 5.
Based on expert opinion and retrospective data the National Institutes of Health (NIH) Consensus Development Project proposed criteria for diagnosis and staging of both overall severity as well as organ severity of chronic graft-versus-host disease (cGVHD) for use in clinical trials. In 2008, representatives of German and Austrian allogeneic hematopoietic stem cell transplant (HSCT) centers established a study group on cGVHD during the annual meeting of the German Working Group on Bone Marrow and Blood Stem Cell Transplantation (DAG-KBT) to intensify a dialog among HSCT physicians, pathologists, and medical consultants focusing on the usefulness of the NIH consensus criteria for patient care in clinical practice and to promote collaborations between HSCT centers as well as different medical specialities involved in HSCT. We first conducted a survey of current practices of diagnosis, staging, and overall grading of cGVHD in daily clinical routine by sending an electronic questionnaire to the heads of the HSCT centers. During 3 meetings in 2009, more representatives of allogeneic HSCT centers were included into the discussion process, resulting in 81% participation representing 88% of all allogeneic HSCT activities in Germany, Austria, and Switzerland. During the third consensus meeting held in Regensburg, Germany, from November 6 to November 7, 2009, important agreements were achieved among participant having a strong impact on care of patients with cGVHD. Areas of disagreement such as distinction between classical NIH cGVHD and overlap syndrome or assignment of liver GVHD after day 100 to acute or chronic category will be further assessed in prospective observational studies among participants in the near future.
基于专家意见和回顾性数据，美国国立卫生研究院（NIH）共识发展项目提出了用于临床试验的慢性移植物抗宿主病（cGVHD）整体严重程度和器官严重程度的诊断和分期标准。2008 年，德国和奥地利异基因造血干细胞移植（HSCT）中心的代表在德国骨髓和血液干细胞移植工作组（DAG-KBT）年会上成立了一个 cGVHD 研究小组，旨在加强 HSCT 医生、病理学家和医学顾问之间的对话，重点关注 NIH 共识标准在临床实践中对患者护理的实用性，并促进 HSCT 中心以及参与 HSCT 的不同医学专业之间的合作。我们首先通过向 HSCT 中心的负责人发送电子问卷，对日常临床实践中 cGVHD 的诊断、分期和整体分级的现行做法进行了调查。在 2009 年的 3 次会议上，更多的异基因 HSCT 中心的代表被纳入讨论过程，代表了德国、奥地利和瑞士所有异基因 HSCT 活动的 81%，参与率为 88%。在 2009 年 11 月 6 日至 7 日于德国雷根斯堡举行的第三次共识会议上，与会者达成了重要协议，对 cGVHD 患者的护理产生了重大影响。在不久的将来，参与者将在前瞻性观察研究中进一步评估诸如在经典 NIH cGVHD 和重叠综合征之间进行区分或在 100 天后将肝脏 GVHD 分配给急性或慢性类别等存在分歧的领域。
