The Multidisciplinary Approach to cGVHD Diagnosis
Panelists discuss how clinicians typically diagnose chronic graft-vs-host disease (cGVHD) based on clinical features rather than biopsies, except in atypical or uncertain cases.
Diagnosis and Clinical Challenges
For diagnosis, the panel generally relies on clinical features rather than biopsies for typical presentations. Biopsies are pursued when:
- Presentation is atypical or differential diagnosis includes other conditions (eg, infections, drug reactions, malignancy)
- There are isolated liver abnormalities
- Diagnoses are uncertain (eg, myositis, polyarthralgias, atypical skin manifestations)
The panelists emphasized the value of multidisciplinary collaboration with dermatology, pulmonology, and ophthalmology for accurate assessment and diagnosis, particularly for:
- Lung involvement (can be insidious and requires proactive screening with PFTs)
- Ocular assessment (Schirmer test for dryness)
- Skin assessment (looking for changes that may be missed)
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