Division of Clinical Research, Fred Hutchinson Cancer Research Center, Seattle, WA 98109-1024, USA.
Blood. 2011 Sep 8;118(10):2679-87. doi: 10.1182/blood-2011-04-314815. Epub 2011 Jun 30.
Since the National Institutes of Health Chronic Graft-Versus-Host Disease (cGVHD) Consensus Project in 2005, a need has emerged to evaluate cGVHD more methodically, not only to make a cGVHD diagnosis, but also to accurately classify individual organ and global organ severity, at baseline and in follow-up so that subjects participating in clinical trials may reliably be assigned an accurate response category irrespective of the evaluator. Even for patients not enrolled on a clinical trial, periodic complete cGVHD assessments can allow subtle manifestations to be detected, monitored carefully, and/or treated early with the goal of hopefully avoiding progression to highly morbid, difficult to treat, and quite often irreversible forms of cGVHD. Early feedback has been that the National Institutes of Health approach to diagnosis classification, staging, and response, as well as other new assessment tools, are too detailed and overly complex. This article tries to address many of these issues by describing how I conduct a comprehensive cGVHD assessment using a streamlined and reliable method that I use regularly within the constraints of a busy clinic.
自 2005 年美国国立卫生研究院慢性移植物抗宿主病（cGVHD）共识项目以来，人们越来越需要更系统地评估 cGVHD，不仅要做出 cGVHD 诊断，还要在基线和随访时准确地分类各个器官和整体器官的严重程度，以便参与临床试验的受试者可以根据评估者准确地分配到准确的反应类别。即使对于未参加临床试验的患者，定期进行全面的 cGVHD 评估也可以发现细微的表现，仔细监测和/或早期治疗，以期避免进展为高度病态、难以治疗且常常不可逆转的 cGVHD 形式。早期的反馈是，美国国立卫生研究院的诊断分类、分期和反应方法，以及其他新的评估工具，过于详细和过于复杂。本文试图通过描述我如何使用一种简化和可靠的方法进行全面的 cGVHD 评估来解决其中的许多问题，这种方法是我在繁忙的诊所中经常使用的。
