Table 3 Comparison of the different guidelines available for chronic GvHD assessment: overall severity staging

From: EBMT−NIH−CIBMTR Task Force position statement on standardized terminology & guidance for graft-versus-host disease assessment

 

Original Seattle criteria [21]

Revised Seattle criteria [22]

NIH criteria (2005 [17] and 2014 [18])

Diagnosis

 

NA

NA

Based on either the presence of specific diagnostic signs or distinctive signs accompanied by additional confirmation (e.g. biopsy or other objective diagnostic test) in at least one target organ (skin & appendages, mouth, eyes, genitalia, esophagus, lungs and muscles & fascia)

Severity Scoring

 Limited

Limited skin AND/OR limited hepatic involvement

Limited skin AND/OR limited hepatic involvement OR single organ sicca syndrome (eyes, mouth, vagina)

Mild

No more than two organs with a scorea of 1, except for lung

 Extensive

Generalized skin involvement AND/OR major hepatic complications AND/OR an isolated sicca syndrome of the eyes, mouth AND/OR any other organ involvement

Generalized skin involvement AND/OR major hepatic complications AND/OR multiple organs involved (more than two, including “nails”), the presence of skin sclerosis/serositis or fasciitis, bronchiolitis obliterans, decreased performance status (<60% Karnofsky−Lansky index) or weight loss >15%

Moderate

Any other severity scoringa not included in the mild or severe categories

   

Severe

At least one organ with a scorea of 3 or a lung scorea of 2

  1. GvHD graft versus host disease, NA not applicable, NIH National Institutes of Health
  2. a Based on specific severity criteria described individually for the manifestations of chronic GvHD in eight target organs (skin & appendages, mouth, eyes, genitalia, GI tract, liver, lungs and muscles & fascia) and measured on a range of 0 (absent) to 3 (severe) for each organ [18]
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