Diagnosis of cGVHD: Challenges & Considerations

Difficult-to-Diagnose Manifestations

The panelists discussed challenging presentations:

• Pulmonary involvement is often insidious, requiring careful monitoring with serial PFTs
• Genital/gynecologic involvement is often underdiagnosed but impacts quality of life significantly
• Neuropathies are difficult to attribute to cGVHD due to multiple potential causes
• Peripheral edema can make assessment of skin thickening/sclerosis challenging
• Serositis (inflammation of tissue lining around heart, lungs, abdomen) is difficult to diagnose and manage
• Immune cytopenias within the cGVHD syndrome can be challenging

Early detection strategies include:

• Serial PFTs (pre-transplant, day 80-90, 6 months, 12 months, 18 months, 2 years)
• Early ophthalmology and dental evaluations
• Patient education about reporting symptoms early
• Regular scheduled follow-ups via telehealth or in-person