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Table 1 Clinical grading system for acute and chronic graft versus host disease

From: Clinical versus histological grading in the assessment of cutaneous graft versus host disease

Clinical grading acute GvHDa Total clinical grade acute GvHDa Clinical grading chronic GvHDc
Grade per organ Involvement skin: % body surface area Involvement GI: volume diarrhea (ml/day) Involvement liver: level bilirubin (μmol/l) Total grade aGvHD Skin grade GI grade Liver grade Clinical performance Grade Criteria
0 No rash caused by GvHD < 500 < 20 0 0 0 0 Normal Limited Only involvement of skin and liver
1 < 25% 500–1000; or nausea and vomiting with positive biopsy 20–40; with moderate increase in ASAT (150–170 IU) 1 1–2 0 0 Normal Extensive Involvement of skin, liver, and any other organ
2 25–50% 1000–1500; or more severe nausea and vomiting 40–75 2b 1–3 1 1 Mildly decreased   
3 > 50% 1500–2000; or more severe nausea and vomiting 75–200 3b 2–3 2–3 2–4 Markedly decreased   
4 > 50% with bullous formation or desquamation > 2000; or severe abdominal pain with or without ileus > 200 4 2–4 2–4 2–4 Extremely decreased   
  1. aGrading adapted from Glucksberg et al. [14] and Przepiorka et al. [15]
  2. bGrades 2 and 3 must involve GI and liver at indicated organ grades, in addition to skin involvement
  3. cGrading according to the Seattle criteria by Shulman et al. [1]