International Chronic Ocular Graft-vs-Host-Disease (GVHD) Consensus Group: proposed diagnostic criteria for chronic GVHD (Part I)
Yoko Ogawa, Stella K Kim, Reza Dana, Janine Clayton, Sandeep Jain, Mark I Rosenblatt, Victor L Perez, Hasanain Shikari, Anjo Riemens, Kazuo Tsubota, Yoko Ogawa, Stella K Kim, Reza Dana, Janine Clayton, Sandeep Jain, Mark I Rosenblatt, Victor L Perez, Hasanain Shikari, Anjo Riemens, Kazuo Tsubota
Abstract
The International Chronic Ocular GVHD Consensus Group held 4 working meetings to define new diagnostic metrics for chronic ocular graft-versus-host disease (GVHD). After considering the factors currently used to diagnose chronic ocular GVHD, the Consensus Group identified 4 subjective and objective variables to measure in patients following allogeneic hematopoietic stem cell transplantation (HSCT): OSDI, Schirmer's score without anesthesia, corneal staining, and conjunctival injection. Each variable was scored 0-2 or 0-3, with a maximum composite score of 11. Consideration was also given to the presence or the absence of systemic GVHD. On the basis of their composite score and the presence or absence of systemic GVHD, patients were assigned to one of three diagnostic categories: NO, PROBABLE, or DEFINITE ocular GVHD. New diagnostic criteria for chronic ocular GVHD are presented by the Consensus Group. Validation studies are needed to identify the best combination of the proposed metrics to maximize diagnostic sensitivity and specificity.
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References
- Shulman H. M. et al. Chronic graft-versus-host syndrome in man. A long-term clinicopathologic study of 20 Seattle patients. Am J Med 69, 204–217 (1980).
- Jabs D. A. et al. The eye in bone marrow transplantation. III. Conjunctival graft-vs-host disease. Arch Ophthalmol 107, 1343–1348 (1989).
- Ogawa Y. et al. Dry eye after haematopoietic stem cell transplantation. Br J Ophthalmol 83, 1125–1130 (1999).
- Balaram M. & Dana M. R. Phacoemulsification in patients after allogeneic bone marrow transplantation. Ophthalmology 108, 1682–1687 (2001).
- Couriel D. R. et al. Extracorporeal photochemotherapy for the treatment of steroid-resistant chronic GVHD. Blood 107, 3074–3080 (2006).
- Kim S. K. Update on ocular graft versus host disease. Curr Opin Ophthalmol 17, 344–348 (2006).
- Lew J. & Smith J. A. Mucosal graft-vs-host disease. Oral Dis 13, 519–529 (2007).
- Riemens A., te Boome L., Imhof S., Kuball J. & Rothova A. Current insights into ocular graft-versus-host disease. Curr Opin Ophthalmol 21, 485–494 (2010).
- Townley J. R., Dana R. & Jacobs D. S. Keratoconjunctivitis sicca manifestations in ocular graft versus host disease: pathogenesis, presentation, prevention, and treatment. Semin Ophthalmol 26, 251–260 (2011).
- Jacobs R. et al. Prevalence and risk factors associated with development of ocular GVHD defined by NIH consensus criteria. Bone Marrow Transplant 47, 1470–1473 (2012).
- Hessen M. & Akpek E. K. Ocular graft-versus-host disease. Curr Opin Allergy Clin Immunol 12, 540–547 (2012).
- Shikari H., Antin J. H. & Dana R. Ocular Graft-versus-Host Disease: A Review. Surv Ophthalmol (2013).
- The definition and classification of dry eye disease: report of the Definition and Classification Subcommittee of the International Dry Eye WorkShop (2007). Ocul Surf 5, 75–92 (2007).
- Ferrara J. L., Levine J. E., Reddy P. & Holler E. Graft-versus-host disease. Lancet 373, 1550–1561 (2009).
- Filipovich A. H. 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 11, 945–956 (2005).
- Dietrich-Ntoukas T. et al. Diagnosis and treatment of ocular chronic graft-versus-host disease: report from the German-Austrian-Swiss Consensus Conference on Clinical Practice in chronic GVHD. Cornea 31, 299–310 (2012).
- Dignan F. L. et al. Organ-specific management and supportive care in chronic graft-versus-host disease. Br J Haematol 158, 62–78 (2012).
- Westeneng A. C. et al. Ocular graft-versus-host disease after allogeneic stem cell transplantation. Cornea 29, 758–763 (2010).
- Ogawa Y., Shimmura S., Dogru M. & Tsubota K. Immune processes and pathogenic fibrosis in ocular chronic graft-versus-host disease and clinical manifestations after allogeneic hematopoietic stem cell transplantation. Cornea 29, S68–S77 (2010).
- Riemens A., Stoyanova E., Rothova A. & Kuiper J. Cytokines in tear fluid of patients with ocular graft-versus-host disease after allogeneic stem cell transplantation. Mol Vis 18, 797–802 (2012).
- Inamoto Y. et al. Validation of measurement scales in ocular graft-versus-host disease. Ophthalmology 119, 487–493 (2012).
- Wang Y. et al. Baseline profiles of ocular surface and tear dynamics after allogeneic hematopoietic stem cell transplantation in patients with or without chronic GVHD-related dry eye. Bone Marrow Transplant (2009).
- Mencucci R. et al. Ophthalmological aspects in allogenic bone marrow transplantation: Sjogren-like syndrome in graft-versus-host disease. Eur J Ophthalmol 7, 13–18 (1997).
- Tichelli A. Late ocular complications after bone marrow transplantation. Nouv Rev Fr Hematol 36 Suppl 1, S79–82 (1994).
- Jack M. K., Jack G. M., Sale G. E., Shulman H. M. & Sullivan K. M. Ocular manifestations of graft-v-host disease. Arch Ophthalmol 101, 1080–1084 (1983).
- Jabs D. A. et al. The eye in bone marrow transplantation. II. Histopathology. Arch Ophthalmol 101, 585–590 (1983).
- Hirst L. W., Jabs D. A., Tutschka P. J., Green W. R. & Santos G. W. The eye in bone marrow transplantation. I. Clinical study. Arch Ophthalmol 101, 580–584 (1983).
- Franklin R. M. et al. Ocular manifestations of graft-vs-host disease. Ophthalmology 90, 4–13 (1983).
- Greinix H. T. et al. Diagnosis and staging of chronic graft-versus-host disease in the clinical practice. Biol Blood Marrow Transplant 17, 167–175 (2011).
- Kamoi M. et al. Donor-recipient gender difference affects severity of dry eye after hematopoietic stem cell transplantation. Eye (Lond) 25, 860–865 (2011).
- Takahashi S. et al. Comparative single-institute analysis of cord blood transplantation from unrelated donors with bone marrow or peripheral blood stem-cell transplants from related donors in adult patients with hematologic malignancies after myeloablative conditioning regimen. Blood 109, 1322–1330 (2007).
- Uchino M. et al. Comparison of stem cell sources in the severity of dry eye after allogeneic haematopoietic stem cell transplantation. Br J Ophthalmol 96, 34–37 (2012).
- Rojas B. et al. Cell populations and adhesion molecules expression in conjunctiva before and after bone marrow transplantation. Exp Eye Res 81, 313–325 (2005).
- Auw-Haedrich C. et al. Histological and immunohistochemical characterisation of conjunctival graft vs host disease following haematopoietic stem cell transplantation. Graefes Arch Clin Exp Ophthalmol 245, 1001–1007 (2007).
- Ogawa Y. et al. Epithelial mesenchymal transition in human ocular chronic graft-versus-host disease. Am J Pathol 175, 2372–2381 (2009).
- Robinson M. R. et al. Topical corticosteroid therapy for cicatricial conjunctivitis associated with chronic graft-versus-host disease. Bone Marrow Transplant 33, 1031–1035 (2004).
- Tatematsu Y. et al. Mucosal microvilli in dry eye patients with chronic GVHD. Bone Marrow Transplant 47, 416–425 (2012).
- Hanada R. & Ueoka Y. Obstruction of nasolacrimal ducts closely related to graft-versus-host disease after bone marrow transplantation. Bone Marrow Transplant 4, 125–126 (1989).
- Ogawa Y. et al. A significant role of stromal fibroblasts in rapidly progressive dry eye in patients with chronic GVHD. Invest Ophthalmol Vis Sci 42, 111–119 (2001).
- Kamoi M. et al. Spontaneous lacrimal punctal occlusion associated with ocular chronic graft-versus-host disease. Curr Eye Res 32, 837–842 (2007).
- Ban Y. et al. Morphologic evaluation of meibomian glands in chronic graft-versus-host disease using in vivo laser confocal microscopy. Mol Vis 17, 2533–2543 (2011).
- Espana E. M., Shah S., Santhiago M. R. & Singh A. D. Graft versus host disease: clinical evaluation, diagnosis and management. Graefes Arch Clin Exp Ophthalmol (2013).
- Schiffman R. M., Christianson M. D., Jacobsen G., Hirsch J. D. & Reis B. L. Reliability and validity of the Ocular Surface Disease Index. Arch Ophthalmol 118, 615–621 (2000).
- Miller K. L. et al. Minimal clinically important difference for the ocular surface disease index. Arch Ophthalmol 128, 94–101 (2010).
- Sullivan B. D. et al. An objective approach to dry eye disease severity. Invest Ophthalmol Vis Sci 51, 6125–6130 (2010).
- Bron A. J., Evans V. E. & Smith J. A. Grading of corneal and conjunctival staining in the context of other dry eye tests. Cornea 22, 640–650 (2003).
- Efron N. Grading scales for contact lens complications. Ophthalmic Physiol Opt 18, 182–186 (1998).
- Dogru M. et al. Changing trends in the definition and diagnosis of dry eyes. Am J Ophthalmol 140, 507–508 (2005).
- Wang Y. et al. Baseline profiles of ocular surface and tear dynamics after allogeneic hematopoietic stem cell transplantation in patients with or without chronic GVHD-related dry eye. Bone Marrow Transplant 45, 1077–1083 (2010).
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