Methods to Assess Disease Activity and Severity in Cutaneous Chronic Graft-versus-Host Disease: A Critical Literature Review

Hadir Shakshouk, Eric R. Tkaczyk, Edward W. Cowen, Rokea A. el-Azhary, Shahrukh K. Hashmi, Saad J. Kenderian, Julia S. Lehman

Research output: Contribution to journalReview articlepeer-review

Abstract

Chronic graft-versus-host disease (cGVHD), a potentially debilitating complication of hematopoietic cell transplantation, confers increased risk for mortality. Whereas treatment decisions rely on an accurate assessment of disease activity/severity, validated methods of assessing cutaneous cGVHD activity/severity appear to be limited. In this study, we aimed to identify and evaluate current data on the assessment of disease activity/severity in cutaneous cGVHD. Using modified PRISMA methods, we performed a critical literature review for relevant articles. Our literature search identified 1741 articles, of which 1635 were excluded as duplicates or failure to meet inclusion criteria. Of the included studies (n = 106), 39 (37%) addressed clinical and/or histopathologic parameters, 53 (50%) addressed serologic parameters, 8 (7.5%) addressed imaging parameters, and 6 (5.5%) addressed computer-based technologies. The only formally validated metric of disease activity/severity assessment in cutaneous cGVHD is the National Institutes of Health consensus scoring system, which is founded on clinical assessment alone. The lack of an objective marker for cGVHD necessitates further studies. An evaluation of the potential contributions of serologic, imaging, and/or computer-based technologies is warranted.

Original languageEnglish (US)
Pages (from-to)738-746
Number of pages9
JournalTransplantation and Cellular Therapy
Volume27
Issue number9
DOIs
StatePublished - Sep 2021

Keywords

  • Disease activity
  • GVHD
  • Graft-versus-host disease
  • Monitoring
  • Sclerotic GVHD
  • dermatology
  • skin
  • skin biopsy

ASJC Scopus subject areas

  • Hematology
  • Transplantation
  • Immunology and Allergy
  • Cell Biology
  • Molecular Medicine
  • Medicine(all)

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