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Consensus diagnostic histopathological criteria for acute gastrointestinal graft versus host disease improve interobserver reproducibility

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Abstract

Graft versus host disease (GvHD) is a clinically important complication after allogeneic hematopoietic stem cell transplantation (HSCT). Its diagnosis relies on clinical and histopathological findings. In order to evaluate and improve inter-institutional diagnostic agreement on histological diagnosis and grading of acute gastrointestinal GvHD, we conducted a round robin test, which included 33 biopsies from 23 patients after HSCT. Five pathologists from different institutions independently evaluated the original sections from the biopsies submitted for diagnosis. Based on their results, consensus qualitative criteria for the assessment of typical histological features of GvHD (e.g., apoptosis, crypt destruction, mucosa denudation) were proposed, including detailed descriptions as well as histological images. In a second round robin test with involvement of the same pathologists, the reproducibility of both diagnosis and grading had improved. Remaining differences were mostly related to differential diagnostic considerations, including viral infection or toxic side effects of medication, which should be resolved by integrating histopathological findings with proper clinical information.

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Acknowledgments

The presented study was approved by the ethical committee of the medical board of Rhineland Palatinate (Nr. 0837.271.12 (8372)).

Conflict of interest

The authors declare that they have no competing interests.

Author information

Authors and Affiliations

  1. Institute of Pathology, University Medical Center Mainz, Langenbeckstr. 1, 55101, Mainz, Germany

    Andreas Kreft

  2. Institute of Pathology, University of Würzburg and Comprehensive Cancer Centre Mainfranken, Josef-Schneider-Str. 2, 97080, Würzburg, Germany

    Anja Mottok

  3. Institute of Pathology, Medical University of Vienna, AKH, Währinger Gürtel 18 –20, A-1090, Vienna, Austria

    Ildiko Mesteri

  4. Department of Pathology, Duke University Medical Center, BOX 3712, Durham, NC, 27713, USA

    Diana M. Cardona

  5. Université Paris Diderot, Laboratoire de Pathologie, UMR_S1165, F-75010, Paris, France

    Anne Janin

  6. Department of Pathology, AP-HP, Hôpital Saint-Louis, F-75010, Paris, France

    Anne Janin

  7. Department of Medicine I for Gastroenterology, Infectious Disease and Rheumatology, Campus Benjamin Franklin, Charité - Universitätsmedizin Berlin, Hindenburgdamm 30, 12203, Berlin, Germany

    Anja A. Kühl

  8. Institute of Pathology, Heidelberg University Hospital, Heidelberg, Germany

    Mindaugas Andrulis

  9. Department of Pathology, Division of General Pathology, Medical University of Innsbruck, Muellerstrasse 44, A-6020, Innsbruck, Austria

    Andrea Brunner

  10. Seattle Cancer Center Alliance, Room G7-910, 825 Eastlake ave E, Seattle, WA, 98109, USA

    Howard M. Shulman

  11. Department of Pathology, Central Hospital Bolzano, Via Boehler 5, I-39100, Bolzano, Italy

    Giovanni Negri

  12. Institute of Pathology, University Hospital Basel, Schoenbeinstr. 40, CH-4031, Basel, Switzerland

    Alexandar Tzankov

  13. Institute of Pathology, University Hospital Regensburg, Franz-Josef-Strauss-Allee 11, 93053, Regensburg, Germany

    Elisabeth Huber

Authors
  1. Andreas Kreft
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  2. Anja Mottok
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  3. Ildiko Mesteri
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  4. Diana M. Cardona
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  5. Anne Janin
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  6. Anja A. Kühl
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  7. Mindaugas Andrulis
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  8. Andrea Brunner
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  9. Howard M. Shulman
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  10. Giovanni Negri
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  11. Alexandar Tzankov
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  12. Elisabeth Huber
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on behalf of the Gastrointestinal Pathology Group of the German-Austrian-Swiss GvHD Consortium

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Correspondence to Andreas Kreft.

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Kreft, A., Mottok, A., Mesteri, I. et al. Consensus diagnostic histopathological criteria for acute gastrointestinal graft versus host disease improve interobserver reproducibility. Virchows Arch 467, 255–263 (2015). https://doi.org/10.1007/s00428-015-1803-y

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  • DOI: https://doi.org/10.1007/s00428-015-1803-y

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