Comparison of the classic Glucksberg criteria and the IBMTR Severity Index for grading acute graft-versus-host disease following HLA-identical sibling stem cell transplantation

  title={Comparison of the classic Glucksberg criteria and the IBMTR Severity Index for grading acute graft-versus-host disease following HLA-identical sibling stem cell transplantation},
  author={Rodrigo Martino and Pablo Romero and Maricel Subir{\'a} and Mar Bellido and Alberto Alt{\'e}s and Anna Sureda and Salut Brunet and Isabel Badell and Jos{\'e} Ram{\'o}n Estela Cubells and Josep M. Sierra},
  journal={Bone Marrow Transplantation},
Acute graft-versus-host disease (AGVHD) severity is usually graded (grades 0–IV) by the pattern of organ involvement using the classic Glucksberg–Seattle criteria (GSC). Recently, the International Bone Marrow Transplant Registry (IBMTR) developed a new Severity Index by regrouping the patterns of organ involvement into five Indexes (0–D) that appeared more predictive of transplant-related mortality (TRM) and transplant failure (TF, relapse or TRM). We studied the predictive value of both… 

Prospective evaluation of 2 acute graft-versus-host (GVHD) grading systems: a joint Société Française de Greffe de Moëlle et Thérapie Cellulaire (SFGM-TC), Dana Farber Cancer Institute (DFCI), and International Bone Marrow Transplant Registry (IBMTR) prospective study.

The 2 classifications performed similarly in explaining variability in survival by aGVHD grade, although the Glucksberg classification predicted early survival better, andValidity of these results in populations receiving peripheral blood transplants or nonmyeloablative conditioning regimens remains to be tested.

What predicts high risk acute graft‐versus‐host disease (GVHD) at onset?: identification of those at highest risk by a novel acute GVHD risk score

Patients with HR acute GVHD have a poor prognosis, require alternative initial therapy and should be the focus of novel therapeutic trials.

Prospective grading of graft-versus-host disease after unrelated donor marrow transplantation: a grading algorithm versus blinded expert panel review.

  • D. WeisdorfD. Hurd N. Kernan
  • Medicine
    Biology of blood and marrow transplantation : journal of the American Society for Blood and Marrow Transplantation
  • 2003

A refined risk score for acute graft-versus-host disease that predicts response to initial therapy, survival, and transplant-related mortality.

  • M. MacMillanM. Robin D. Weisdorf
  • Medicine, Biology
    Biology of blood and marrow transplantation : journal of the American Society for Blood and Marrow Transplantation
  • 2015

A refined risk score for acute GVHD that predicts response to initial therapy, survival and transplant-related mortality

A refined definition of acute GVHD risk, which is a better predictor of response, survival and transplant-related mortality than other published acute GvHD risk scores, is validated.

Steroid treatment of acute graft-versus-host disease grade I: a randomized trial

In conclusion, steroid treatment of acute grade I GvHD prevents progression to grade II but not to grade III–IV Gv HD, and there is no effect on non-relapse mortality and survival.

Reduced incidence of acute graft versus host disease (GVHD) of the gut in Chinese carriers of Helicobacter Pylori during allogeneic bone marrow transplantation

The reduced risk of immune-mediated gut inflammation in H. Pylori carriers after SCT may be related to the known reduced incidence of inflammatory bowel disease in chronic H.

The association of histologic grade with acute graft‐versus‐host disease response and outcomes

Histologic GVHD grade is correlated with clinical grading and treatment response, and may play a role in further predicting severity andreatment response of acute GV HD.

Differential Interaction of Peripheral Blood Lymphocyte Counts (ALC) With Different in vivo Depletion Strategies in Predicting Outcomes of Allogeneic Transplant: An International 2 Center Experience

Like ATG, there is definite but differential interaction between the recipient peripheral blood ALC and alemtuzumab dose to predict OS, DFS, and relapses.

Similar outcomes of alemtuzumab-based hematopoietic cell transplantation for SAA patients older or younger than 50 years.

Effect of comorbidities rather than age alone may be a more important determinant of suitability for FCC HSCT in older patients.




An acute GVHD Severity Index is proposed to enhance design and interpretation of clinical trials in the current era of allogeneic blood and bone marrow transplantation.

Acute graft-versus-host disease: grade and outcome in patients with chronic myelogenous leukemia. Working Party Chronic Leukemia of the European Group for Blood and Marrow Transplantation.

The Working Party Chronic Leukemia of the European Group for Bone Marrow Transplantation analyzed data of 1,294 patients transplanted from an allogeneic donor for chronic myelogenous leukemia (CML) in first chronic phase and tested the predictive value of aGVHD grading for the following end-points, documenting the value of the present 5-point grading.

Treatment of moderate/severe acute graft-versus-host disease after allogeneic bone marrow transplantation: an analysis of clinical risk features and outcome.

Analysis of clinical features associated with complete response (CR) to acute GVHD therapy identified more favorable responses to therapy in patients without either liver or skin involvement, patients with acute lymphoblastic leukemia, and donor/recipient pairs other than male patients with female donors.

Reproducibility in retrospective grading of acute graft-versus-host disease after allogeneic marrow transplantation

Current criteria for assessing the severity of GVHD by a single reviewer are not sufficiently reliable for rigorous clinical studies, and the proposed revised criteria might yield more reproducible retrospective grading than the original criteria.

1994 Consensus Conference on Acute GVHD Grading.

Reports of GVHD prevention trials should include an accurate description of the grading system used and should report actuarial rates of grades II-IV and III-IV GV HD corrected for graft failure and potential interventions for early relapse.


The results show that despite histocompatibility matching and methotrexate therapy, GVHD remains a serious and often fatal complication of marrow transplantation.

A retrospective analysis of therapy for acute graft-versus-host disease: secondary treatment

The times to treatment failure and the proportions of patients in various response categories were similar for primary and secondary treatment, suggesting that the potential efficacy of new immunosuppressive agents for treatment of acute GVHD can be assessed meaningfully in patients who have not responded adequately to initial therapy.

Prevention and treatment of acute graft-versus-host disease: the old and the new. A report from The Eastern Cooperative Oncology Group (ECOG)

The evaluation of these new agents and the approach to be taken is hampered by the realization that most patients have received and are relatively refractory to standard therapies, so clinical trials must be performed earlier in the course of the syndrome to establish the role of these compounds.

Allogeneic transplantation of selected CD34+ cells from peripheral blood: experience of 62 cases using immunoadsorption or immunomagnetic technique

It is indicated that allogeneic transplantation of selected CD34+ cells is associated with a very rapid engraftment and with a low incidence of severe GVHD and stronger TCD is obtained as compared to immunoadsorption.

Low-dose donor CD8+ cells in the CD4-depleted graft prevent allogeneic marrow graft rejection and severe graft-versus-host disease for chronic myeloid leukemia patients in first chronic phase

The pilot study of T cell subset depletion in patients with chronic myelogenous leukemia in first chronic phase receiving a bone marrow transplant from an HLA-identical sibling shows the importance of CD8+ cells to ensure correct engraftment, decreasing the GVHD rate.