Clinical Perspectives: Risk Factors and Patient Characteristics Associated with cGVHD
Panelists discuss how posttransplant cyclophosphamide has changed the clinical presentation of chronic graft-vs-host disease (cGVHD), with potentially lower incidence but similar severity when it does occur.
Clinical Prevalence and Risk Factors
The panel discussed the frequency of cGVHD in clinical practice:
- Common risk factors include HLA disparity, donor characteristics, and GVHD prophylaxis regimen
- Post-transplant cyclophosphamide has reduced overall incidence of cGVHD, though severity remains similar when it does occur
- The panel still quotes patients approximately 50% risk of developing cGVHD
Most common manifestations in practice are:
- Eyes, mouth, and skin (consensus among all panelists)
- Ocular GVHD may be underdiagnosed; at Fred Hutch, patients receive specialized ophthalmologic evaluation at day 80-90 departure workup, capturing subclinical cases
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