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aGvHDtrackR and cGvHDtrackR: shiny applications for graft versus host disease management and clinical data collection

Bone Marrow Transplantation volume 60, pages 389–392 (2025)Cite this article

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Abstract

Graft-versus-host disease (GvHD) is one of the most common and troublesome complications after allogeneic hematopoietic stem cell transplantation (HSCT). Despite adequate GvHD prophylaxis, 30-50% of the patients still develop acute or chronic GvHD, often requiring multiple lines of therapy. Therefore, it is crucial to closely monitor the onset and the response of GvHD to therapies to identify the best available treatment for each patient. Currently, some applications (desktop or mobile) that allow to score GvHD severity at the bedside are available. However, none of the published systems is designed to record ongoing therapies and to upload data in a database, which can support both the clinical decision-making process as well as data collection. To this aim, we developed two Shiny apps: aGvHDtrackR for acute GvHD and cGvHDtrackR for chronic GvHD. These applications record GvHD grading alongside the therapies used for each patient and allow to export of the data in a longitudinal patient-specific database. This is of help for the clinical management of patients and for future multicentric studies on GvHD.

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Fig. 1: Description of GvHDtrackR interface.
Fig. 2: Example of data that can be collected with the apps.

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Data availability

GvHDtrackR is available for download at: Sync.com at: https://ln5.sync.com/dl/e32046ed0#cjy27czs-4s4bunnv-bjsuzb7k-7q4rr5xg Github at: https://github.com/SindoniMarco/GvHDtrackR.

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Acknowledgements

We thank the Pediatric Team of the Hematopoietic Stem Cell Transplantation Unit at Fondazione IRCCS San Gerardo dei Tintori for feedback and support during the development of the applications.

Funding

We thank Comitato Maria Letizia Verga, Fondazione M. Tettamanti De Marchi and Fondazione Alessandro Maria Zancan “GrandeAle ETS” for supporting clinical and research activity of our Pediatric Department.

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Authors and Affiliations

  1. School of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy

    Marco Maria Sindoni, Francesca Limido, Anita Toso, Adriana Balduzzi & Silvia Nucera

  2. Pediatric Department, Fondazione IRCCS San Gerardo dei Tintori, Monza, Italy

    Giovanna Lucchini & Adriana Balduzzi

  3. Tettamanti Center, Fondazione IRCCS San Gerardo dei Tintori, Monza, Italy

    Giuseppe Gaipa & Silvia Nucera

Authors
  1. Marco Maria Sindoni
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  2. Francesca Limido
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  3. Anita Toso
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  4. Giovanna Lucchini
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  5. Giuseppe Gaipa
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  6. Adriana Balduzzi
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  7. Silvia Nucera
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Contributions

MMS designed and developed the application and wrote the manuscript; FL and AT collected patients’ data and performed the longitudinal analysis GvHD; GL tested the apps' functionality and accuracy; GG contributed to discussion and development; AB supervised and contributed to the development from GvHD expert point and supervised testing with clinical equipe; SN supervised and contributed to the development of the application, wrote the manuscript.

Corresponding authors

Correspondence to Adriana Balduzzi or Silvia Nucera.

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Competing interests

The authors declare no competing interests.

Ethics approval and consent to participate

The paper is focused on the development of an application. The patient whose data were collected as an example to show how the application worked provided his informed consent.

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Sindoni, M.M., Limido, F., Toso, A. et al. aGvHDtrackR and cGvHDtrackR: shiny applications for graft versus host disease management and clinical data collection. Bone Marrow Transplant 60, 389–392 (2025). https://doi.org/10.1038/s41409-025-02509-1

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