Acute Versus Chronic Graft-Versus-Host Disease (GVHD)

Opinion
Video

Drs Yi-Bin Chen, Corey Cutler, Hannah Choe, and Mitchell Horwitz distinguish acute from chronic graft-versus-host disease (GVHD), how such distinction has changed over the last decades, and provide an overview of consensus definitions for disease grading.

This is a video synopsis of a discussion involving Dr Yi-Bin Chen, Director of the Transplant and Cell Therapy Program at Massachusetts General Hospital and Professor of Medicine at Harvard Medical School; Dr Corey Cutler, Director of the Stem Cell Transplant Program at Dana-Farber Cancer Institute and Professor of Medicine at Harvard Medical School; Dr Mitchell Horwitz, Professor of Medicine and Director of the Adult Blood and Marrow Transplant Program at Duke University, and Dr Hannah Choe, Assistant Professor and Director of the Graft-versus-Host-Disease (GVHD) program at Ohio State University.

The panel, led by Dr Yi-Bin Chen, explores the current and emerging treatment landscape for chronic GVHD. The conversation delves into the distinctions between acute and chronic GVHD, with Dr Corey Cutler highlighting the shift from time-based classification to clinical features. Acute GVHD is characterized by a diffuse macular rash, elevated liver function, and watery diarrhea within the first 100 days post-transplant. Chronic GVHD, on the other hand, presents as a pleomorphic disease affecting various organs and can manifest at any time after transplant.

Dr Hannah Choe details the consensus guidelines used for grading acute and chronic GVHD, emphasizing the importance of the NIH consensus criteria for chronic GVHD diagnosis. The criteria break down eight different organ systems, considering the severity of involvement and impact on quality of life. Dr Mitchell Horwitz addresses the challenge of "overlap" GVHD, a type that blurs the distinction between acute and chronic forms, making diagnosis and treatment complex.

The discussion also touches upon the difficulties in managing patients who transition from acute to chronic GVHD, with tapering immunosuppression potentially triggering the development of chronic GVHD. The panelists underscore the ongoing efforts to standardize diagnostic criteria, improve treatment strategies, and enhance overall patient outcomes in the complex landscape of chronic GVHD.

In summary, the panelists share valuable insights into the evolving understanding and management of chronic GVHD.

Video synopsis is AI-generated and reviewed by OncLive® editorial staff.

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