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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]