Table 1 Comparison of the different guidelines available for acute GvHD assessment: individual organ severity staging
Organ Severity Stage | Original Glucksberg criteria [13] | “Modified Glucksberg” or “Keystone” criteria [14] and IBMTR criteria [15] | MAGIC criteria [16] |
|---|---|---|---|
Skin | |||
0 | No rash | No rash | No rash |
1 | Rash < 25% of BSA | Rash < 25% of BSA | Rash < 25% of BSA |
2 | Rash 25% to 50% of BSA | Rash 25% to 50% of BSA | Rash 25% to 50% of BSA |
3 | Rash > 50% of BSA | Rash > 50% of BSA | Rash > 50% of BSA |
4 | Generalized erythroderma with bullous formation | Generalized erythroderma with bullous formation | Generalized erythroderma ( > 50% BSA) plus bullous formation and desquamation >5% of BSA |
Liver | |||
0 | Total serum bilirubin < 34 µmol/L ( < 2 mg/dL) or AST/SGOT 150-750 IU | Total serum bilirubin < 34 µmol/L ( < 2 mg/dL) | Total serum bilirubin < 34 µmol/L ( < 2 mg/dL) |
1 | Total serum bilirubin 34-50 µmol/L (2 to 3 mg/dL) | Total serum bilirubin 34-50 µmol/L (2 to 3 mg/dL) | Total serum bilirubin 34-50 µmol/L (2 to 3 mg/dL) |
2 | Total serum bilirubin 51-102 µmol/L (3.1 to 6 mg/dL) | Total serum bilirubin 51-102 µmol/L (3.1 to 6 mg/dL) | Total serum bilirubin 51-102 µmol/L (3.1 to 6 mg/dL) |
3 | Total serum bilirubin 103-255 µmol/L (6.1 to 15 mg/dL) | Total serum bilirubin 103-255 µmol/L (6.1 to 15 mg/dL) | Total serum bilirubin 103-255 µmol/L (6.1 to 15 mg/dL) |
4 | Total serum bilirubin > 255 µmol/L ( > 15 mg/dL) | Total serum bilirubin > 255 µmol/L ( > 15 mg/dL) | Total serum bilirubin > 255 µmol/L ( > 15 mg/dL) |
Upper GI | |||
0 | NA | No persistent nausea and no histologic evidence of GvHD in the stomach or duodenum | No or intermittenta anorexia or nausea or vomiting |
1 | NA | Persistent nausea with histologic evidence of GvHD in the stomach or duodenum | Persistenta anorexia or nausea or vomiting |
Lower GI | |||
0 | Diarrhea < 500 mL/day | Diarrhea < 500 mL/day | Diarrhea < 500 mL/day or < 3 episodes/day for adultsb,c |
1 | Diarrhea > 500 mL/day | Diarrhea > 500 mL/day | Diarrhea 500-999 mL/day or 3-4 episodes/day for adultsb,d |
2 | Diarrhea > 1000 mL/day | Diarrhea > 1000 mL/day | Diarrhea 1000-1500 mL/day or 5-7 episodes/day for adultsb,e |
3 | Diarrhea > 1500 mL/day | Diarrhea > 1500 mL/day | Diarrhea >1500 mL/day or >7 episodes/day for adultsb,f |
4 | Diarrhea >2000 mL/day | Severe abdominal pain with or without ileus | Severe abdominal pain with or without ileus or grossly bloody stools (regardless of stool volume) |
Karnofsky index | |||
>30% | NA | NA | |
<30% | NA | NA |
