Download Definition of chronic GvHD no no manifestation / no - EWOG-MDS

Definition of chronic GvHD
no
yes
Skin score 1
Skin score 2
Skin score 3
Mouth score 1
Mouth score 2
Mouth score 3
Eyes score 1
Eyes score 2
Eyes score 3
GI tract score 1
GI tract score 2
GI tract score 3
Liver score 1
Liver score 2
Liver score 3
Lungs score 1
Lungs score 2
Lungs score 3
no manifestation / no symptoms
presence of at least 1 diagnostic clinical sign of cGvHD or presence of at least 1 distinctive
manifestation confirmed by pertinent biopsy or other relevant tests
<18% BSA with disease signs but NO sclerotic features
19-50% BSA OR involvement with superficial sclerotic features “not hide-bound” (able to
pinch)
>50% BSA OR deep sclerotic features “hidebound“ (unable to pinch) OR impaired mobility,
ulceration or severe puritus
Mild symptoms with disease signsbut not limiting oral intake significantly
Moderate symptoms with disease signs with partial limitation of oral intake
Severe symptoms with disease signs on examination with major limitation of oral intake
Mild dry eye symptoms not affecting ADL (requiring eyedrops ≤ 3 x per day) OR
asymptomatic signs og keratoconjunctivitis sicca
Moderate dry eye, symptoms partially affecting ADL (requiring eyedrops >3 x per day or
punctual plugs), without vision impairment
Severe dry eye symptoms significantly affecting ADL (special eyeware to relieve pain) OR
unable to work because of ocular symptoms OR loss of vision caused by keratoconjunctivitis
sicca
Symptoms such as dysphagia, anorexia, nausea, vomiting, abdominal pain or diarrhea
without significant weight loss (< 5%)
Symptoms associated with mild to moderate weight loss (5- 15%)
Symptoms associated with significant weightloss >15%, requires nutritional supplement for
most calorie needs OR esophageal dilation
Elevated Bilirubin, AP, AST or ALT <2 x ULN
Bilirubin >3 mg/dl or Bilirubin, enzymes 2-5 x ULN
Bilirubin or enzymes > 5 x ULN
Mild symptoms (shortness of breath after climbing one flight of steps) FEV1 60-79% OR LFS
3-5
Moderate symptoms (shortness of breath after walking on fiat ground) FEV1 40-59% OR LFS
6-9
Severe symptoms (shortness of breath at rest; requiring O2) FEV1 ≤ 39% OR LFS 10-12
Mild tightness of arms or legs, normal or mild de-creased range of motion (ROM) AND not
Joints and Fascia score 1 affecting ADL
Tightness of arms or legs OR joint contractures, erythema thought due to fasciitis, moderate
Joints and Fascia score 2 decrease ROM AND mild to moderate limitation of ADL
Contractures WITH significant decrease of ROM AND significant limitation of ADL (unable to
Joints and Fascia score 3 tie shoes, button shirts, dress self etc.)
Genital Tract score 1
Symptomatic with mild signs on exam AND no effect
on coitus and minimal discomfort with gynecologic exam
Genital Tract score 2
Symptomatic with moderate signs on exam AND with mild dyspareunia or discomfort with
gynecologic exam
Genital Tract score 3
Symptomatic WITH advanced signs (stricture, labial agglutination or severe ulceration) AND
severe pain with coitus or inability to insert vaginal speculum
Performance score 1
KPS, ECOG, LPS
Symptomatic fully ambulatory, restricted only in
physically strenuous, (ECOG 1 KPS or LPS 80- 90%)
Performance score 2
KPS, ECOG, LPS
Symptomatic ambulatory, capable of self-care , >50% of waking hours out of bed (ECOG 2
KPS or LPS 60-70%)
Performance score 3
KPS, ECOG, LPS
Symptomatic limited self-care>50% of waking hours in
bed (ECOG 3-4, KPS or LPS < 60%)
Overall grade of chronic GvHD
Mild chronic GvHD
Moderate chronic GvHD
Severe chronic GvHD
involvement of 1 or 2 organs (exept lung) with a maximum score 1 in all affected
organs or sites
at least 1 organ with a maximum score 2 or 3 or more organs with a maximum
score 1 or a lung score 1
score of 3 in any organ or site or a lung score of ≥ 2