[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"detail-sidebar-cat-0-en-105":3,"doc-seo-508572-105":59,"doc-detail-508572-en":130},{"code":4,"msg":5,"data":6},0,"success",[7,13,18,23,28,33,38,43,48,51,55],{"id":8,"doc_module":4,"doc_module_name":9,"category_name":10,"show_sort_weight":11,"slug":12},1,"Document","Story & Novel",90,"story-novel",{"id":14,"doc_module":4,"doc_module_name":9,"category_name":15,"show_sort_weight":16,"slug":17},2,"Literature",80,"literature",{"id":19,"doc_module":4,"doc_module_name":9,"category_name":20,"show_sort_weight":21,"slug":22},4,"Exam",70,"exam",{"id":24,"doc_module":4,"doc_module_name":9,"category_name":25,"show_sort_weight":26,"slug":27},5,"Comic",60,"comic",{"id":29,"doc_module":4,"doc_module_name":9,"category_name":30,"show_sort_weight":31,"slug":32},6,"Technology",50,"technology",{"id":34,"doc_module":4,"doc_module_name":9,"category_name":35,"show_sort_weight":36,"slug":37},7,"Healthcare",40,"healthcare",{"id":39,"doc_module":4,"doc_module_name":9,"category_name":40,"show_sort_weight":41,"slug":42},8,"Research & Report",30,"research-report",{"id":44,"doc_module":4,"doc_module_name":9,"category_name":45,"show_sort_weight":46,"slug":47},9,"Religion & Spirituality",20,"religion-spirituality",{"id":46,"doc_module":4,"doc_module_name":9,"category_name":49,"show_sort_weight":46,"slug":50},"World Cup","world-cup",{"id":52,"doc_module":4,"doc_module_name":9,"category_name":53,"show_sort_weight":52,"slug":54},10,"Lifestyle","lifestyle",{"id":56,"doc_module":4,"doc_module_name":9,"category_name":57,"show_sort_weight":24,"slug":58},19,"General","general",{"code":4,"msg":60,"data":61},"ok",{"site_id":62,"language":63,"slug":64,"title":65,"keywords":66,"description":67,"schema_data":68,"social_meta":123,"head_meta":125,"extra_data":127,"updated_unix":129},105,"en","acute-and-chronic-graft-versus-host-disease-a-focus-on-pediatric-patients","ACUTE AND CHRONIC GRAFT-VERSUS-HOST-DISEASE - A FOCUS ON PEDIATRIC PATIENTS","","Graft-versus-host disease (GVHD), in both acute and chronic forms, drives morbidity and non-relapse mortality after allogeneic hematopoietic stem cell transplantation (allo-HSCT). Classification advances have improved the applicability and reproducibility of standardized criteria, alongside better steroid-refractory or resistant-case management. In 2020, a Brazilian pediatric task force produced updated, evidence-based guidance for diagnosis, classification, staging, prophylaxis, and treatment, reported here.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/acute-and-chronic-graft-versus-host-disease-a-focus-on-pediatric-patients/508572/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/acute-and-chronic-graft-versus-host-disease-a-focus-on-pediatric-patients/508572.png","ImageObject",300,407,{"name":92,"@type":93},"vwvw","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-29","2026-10-05",true,{"@type":102,"interactionType":103,"userInteractionCount":24},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"What major outcomes does GVHD influence after allo-HSCT?","Question",{"text":112,"@type":113},"GVHD is the main contributor to morbidity and non-relapse mortality after allogeneic hematopoietic stem cell transplantation.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"How did acute GVHD classification change regarding symptom onset?",{"text":117,"@type":113},"From 2005, typical acute GVHD symptoms before D+100 were termed “classical aGVHD,” while symptoms starting after D+100 were classified as “late onset or recurrent aGVHD.”",{"name":119,"@type":110,"acceptedAnswer":120},"What tools or biomarkers are discussed for GVHD risk identification?",{"text":121,"@type":113},"The article reviews biomarker panels (e.g., ST2, REG3α, TNFR1α, IL-2Rα/CD25) and highlights EASIX, which uses LDH, serum creatinine, and platelet count to identify high-risk patients.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},508572,1792640022,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":24,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":139,"language":140,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":141,"faqs":142,"seo_title":143,"seo_description":67,"update_tm":144,"read_time":145,"preview_page_count":4},3985747874149,"https://ap-avatar.wpscdn.com/avatar/3a001161165b4dc3d9e?x-image-process=image/resize,m_fixed,w_180,h_180&k=1790129441039064114","JOURNAL OF BONE MARROW TRANSPLANTATION AND CELLULAR THERAPY JB MT CT  \nDOI: 10.46765/2675-374X.2021v2n2p140  \nACUTE AND CHRONIC GRAFT-VERSUS-HOST-DISEASE – A FOCUS ON PEDIATRIC PATIENTS  \nAntonio Vaz de Macedo1,2, Júlia Lopes Garcia3,4, Roseane Vasconcelos Gouveia5, Rita de Cássia Barbosa Tavares6  \n1. Hematology Clinic, Hospital da Polícia Militar, Belo Horizonte, MG, Brazil.  \n2. Bone Marrow Transplant Unit, Hospital Luxemburgo, Instituto Mário Penna, Belo Horizonte, MG, Brazil.  \n3. Hematopoietic Stem Cell Transplantation Unit, Instituto de Tratamento do Câncer Infantil, Instituto da Criança, Hospital das Clínicas da Faculdade de Medicina da Universidade deSão Paulo, Brazil.  \n4. Hematology and Bone Marrow Transplantation Unit, Hospital Israelita Albert Einstein, São Paulo, Brazil.  \n5. Pediatric Bone Marrow Transplant Unit, Hospital Samaritano, São Paulo, SP, Brazil.  \n6. Bone Marrow Transplant Center-CEMO, Instituto Nacional de Câncer, Rio de Janeiro, RJ, Brazil. [Correspondence to: antoniovmac@hotmail.com](Correspondence to: antoniovmac@hotmail.com)  \nABSTRACT  \nGraft-versus-host disease (GVHD), either in its acute or chronic form, is the main contributory factor for morbidity and non-relapse mortality after allogeneic hematopoietic stem cell transplantation (allo-HSCT) . Recent advancements in the classification of this disease, with better applicability and reproducibility of standardized criteria, coupled with improvements in the management of steroid-refractory or resistant cases, have led to promising results. In 2020, the Brazilian Group for Pediatric Bone Marrow Transplantation of the Brazilian Society for Blood and Marrow Transplantation and Cellular Therapy (SBTMO) convened a task force to provide updated, evidence-based guidance for the diagnosis, classification, staging, prophylaxis, and treatment of GVHD, with a focus on the pediatric population, the results of which are presented here.  \nKeywords: Graft-Versus-Host Disease, Diagnosis, Classification, Grading, Staging, Prophylaxis, Treatment, Hematopoietic Stem Cell Transplantation, Pediatric, Consensus Guidelines.  \nDEFINITION AND RISK FACTORS FOR ACUTE AND CHRONIC GRAFT-VERSUS-HOST DISEASE  \nThe original classification of acute graft-versus-host disease (GVHD) was published in 1974 and was based on time of onset as the sole criterion. From 2005 onwards, patients presenting with typical acute GVHD (aGVHD) symptoms before D+100 were categorized as having “classical aGVHD”, whereas those with such manifestations starting after D+100 were classified as having “late onset or recurrent aGVHD”1.  \nIn 2005, the National Institutes of Health (NIH) published a new set of consensus guidelines harboring both the diagnostic and the grading criteria for chronic GVHD (cGVHD), including various aspects pertaining to the diagnosis, classification, and treatment of this post-hematopoietic stem cell transplant (HSCT) complication1,2 .  \nRoughly a decade later, in 2014, the NIH updated these guidelines, which kept the original structure, but added more robust evidence-based guidance for the diagnosis and management ofcGVHD3. These guidelines focused on controversial aspects, including, but not limited to, the distinction between active disease and prior tissue injury. Additionally, the diagnostic criteria for target-organ involvement, such as mouth, eyes, genitalia, and lungs, were thoroughly revised, and cGVHD-related organ impairment was specifically addressed. In short, this update aimed ata comprehensive diagnostic and prognostic assessment ofcGVHD, as well as at better guidance toward appropriate treatment and defining eligibility for clinical trials, with greater specificity and precision.3.  \nA number of risk factors have been widely recognized as related to an increased incidence of  \n151  \nJOURNAL OF BONE MARROW TRANSPLANTATION AND CELLULAR THERAPY JB MT CT  \naGVHD4,5,6 . These factors may be directly related to the recipient, the donor, the graft, or the HSCT itself.","cbCaisfnpvrJ6LxQ","https://ap.wps.com/l/cbCaisfnpvrJ6LxQ","pdf",415414,26,"English","# Definition and Risk Factors for Acute and Chronic Graft-versus-Host Disease\n## Acute GVHD classification evolution\n## NIH consensus guidelines for chronic GVHD\n## Risk factors and biomarkers\n## EASIX and clinical risk identification\n# Acute GVHD Diagnosis and Clinical Description","[{\"question\":\"What major outcomes does GVHD influence after allo-HSCT?\",\"answer\":\"GVHD is the main contributor to morbidity and non-relapse mortality after allogeneic hematopoietic stem cell transplantation.\"},{\"question\":\"How did acute GVHD classification change regarding symptom onset?\",\"answer\":\"From 2005, typical acute GVHD symptoms before D+100 were termed “classical aGVHD,” while symptoms starting after D+100 were classified as “late onset or recurrent aGVHD.”\"},{\"question\":\"What tools or biomarkers are discussed for GVHD risk identification?\",\"answer\":\"The article reviews biomarker panels (e.g., ST2, REG3α, TNFR1α, IL-2Rα/CD25) and highlights EASIX, which uses LDH, serum creatinine, and platelet count to identify high-risk patients.\"}]","ACUTE AND CHRONIC GRAFT-VERSUS-HOST-DISEASE - A FOCUS ON PEDIATRIC PATIENTS | PDF",1791228413,66]