Abstract
Pathology plays a significant role in the interpretation of surgical biopsies that provide a clinical diagnosis and aid in the management decisions. By evaluating a collection of biopsies, pathology has helped define the natural history of various manifestations of graft-versus-host disease (GVHD). GVHD affects several organs, most commonly the skin, liver, and gastrointestinal tract. Interpretation of these cases requires knowledge and consideration of GVHD's progression over time and the effects of therapeutic intervention on the respective histology. Pathology is required to distinguish infection and other differential diagnoses from GVHD and to differentiate static changes from active changes. The contemporary diagnostic criterion and recommended format for reporting the organs involved with acute and chronic GVHD are presented.
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Similar content being viewed by others
References
Shulman HM, Kleiner D, Lee SJ, et al. Histopathologic diagnosis of chronic graft-versus-host disease: National Institutes of Health consensus development project on criteria for clinical trials in chronic graft-versus-host disease: II. Pathology working group report. Biol Blood Marrow Transplant. 2006;12(1):31–47.
Shulman HM, Cardona DM, Greenson JK, et al. NIH Consensus development project on criteria for clinical trials in chronic graft-versus-host disease: II. The 2014 Pathology working group report. Biol Blood Marrow Transplant. 2015;21(4):589–603.
Filipovich AH, Weisdorf D, Pavletic S, et al. National Institutes of Health consensus development project on criteria for clinical trials in chronic graft-versus-host disease: I. Diagnosis and staging working group report. Biol Blood Marrow Transplant. 2005;11(12):945–56.
Bruggen MC, Klein I, Greinix H, et al. Diverse T-cell responses characterize the different manifestations of cutaneous graft-versus-host disease. Blood. 2014;123(2):290–9.
Nishiwaki S, Terakura S, Ito M, et al. Impact of macrophage infiltration of skin lesions on survival after allogeneic stem cell transplantation: a clue to refractory graft-versus-host disease. Blood. 2009;114(14):3113–6.
Terakura S, Martin PJ, Shulman HM, Storer BE. Cutaneous macrophage infiltration in acute GvHD. Bone Marrow Transplant. 2015;50(8):1135–7.
Inamoto Y, Jagasia M, Wood WA, et al. Investigator feedback about the 2005 NIH diagnostic and scoring criteria for chronic GVHD. Bone Marrow Transplant. 2014;49(4):532–8.
Jacobsohn DA, Montross S, Anders V, Vogelsang GB. Clinical importance of confirming or excluding the diagnosis of chronic graft-versus-host disease. Bone Marrow Transplant. 2001;28(11):1047–51.
Hillen U, Hausermann P, Massi D, et al. Consensus on performing skin biopsies, laboratory workup, evaluation of tissue samples and reporting of the results in patients with suspected cutaneous graft-versus-host disease. J Eur Acad Dermatol Venereol. 2015;29(5):948–54.
Annette S. H. Gouw, Andrew D. Clouston, Neil D. Theise, (2011) Ductular reactions in human liver: Diversity at the interface. Hepatology 54 (5):1853–63
Shulman HM, Sharma P, Amos D, Fenster LF, McDonald GB. A coded histologic study of hepatic graft-versus-host disease after human bone marrow transplantation. Hepatology. 1988;8(3):463–70.
Evans AT, Loeb KR, Shulman HM, et al. Fibrosing cholestatic hepatitis C after hematopoietic cell transplantation: report of 3 fatal cases. Am J Surg Pathol. 2015;39(2):212–20.
Cooksley WG, McIvor CA. Fibrosing cholestatic hepatitis and HBV after bone marrow transplantation. Biomed Pharmacother. 1995;49(3):117–24.
McDonald GB. How I treat acute graft-versus-host disease of the gastrointestinal tract and the liver. Blood. 2016;127(12):1544–50.
Castilla-Llorente C, Martin PJ, McDonald GB, et al. Prognostic factors and outcomes of severe gastrointestinal GVHD after allogeneic hematopoietic cell transplantation. Bone Marrow Transplant. 2014;49(7):966–71.
Sale G, Shulman H, Hackman RC. Pathology of hematopoietic cell transplantation. In: Blume KG, Forman SJ, Appelbaum FR, editors. Thomas’ hematopoietic cell transplantation. 3rd ed. Oxford: Blackwell Publishing Ltd; 2004. p. 286–99.
Myerson D, Steinbach G, Gooley TA, Shulman HM. Graft-versus-host disease of the gut: A histologic activity grading system and validation. Biol Blood Marrow Transplant. 2017;23:1573.
Harris AC, Young R, Devine S, et al. International, multicenter standardization of acute graft-versus-host disease clinical data collection: A report from the Mount Sinai acute GVHD international consortium. Biol Blood Marrow Transplant. 2016;22(1):4–10.
Cooke KR, Luznik L, Sarantopoulos S, et al. The biology of chronic graft-versus-host disease: A task force report from the National Institutes of Health consensus development project on criteria for clinical trials in chronic graft-versus-host disease. Biol Blood Marrow Transplant. 2017;23(2):211–34.
Abu Zaid M, Wu J, Wu C, et al. Plasma biomarkers of risk for death in a multicenter phase 3 trial with uniform transplant characteristics post-allogeneic HCT. Blood. 2017;129(2):162–70.
Paczesny S. Biomarkers for post-transplantation outcomes. Blood. 2018;131:2193.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2019 Springer Nature Switzerland AG
About this chapter
Cite this chapter
Shulman, H.M. (2019). The Contributions of Pathology to the Diagnosis and Management of GVHD: Caveats and Lessons Learned. In: Yeung, C., Shulman, H. (eds) Pathology of Graft vs. Host Disease. Springer, Cham. https://doi.org/10.1007/978-3-319-42099-8_1
Download citation
DOI: https://doi.org/10.1007/978-3-319-42099-8_1
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-319-42098-1
Online ISBN: 978-3-319-42099-8
eBook Packages: MedicineMedicine (R0)