Evidence map›Paper›PMID 41539488›Full record

GuidelineTransplantation and cellular therapy2026

Toward Better Response Assessment of Cutaneous Chronic Graft-Versus-Host Disease: A Report from the National Institutes of Health Consensus Project Task Force.

Alina Markova, Stephanie J Lee, Badri Modi, Emily Baumrin, Rachel K Rosenstein, Eric R Tkaczyk, Julia S Lehman, Yoshihiro Inamoto, Paul A Carpenter, Kirk R Schultz and 13 more

Abstract readPractice GuidelineReview
In one paragraph

Guideline in Transplantation and cellular therapy, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Trial
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

23 authors.

Alina MarkovaDermatology Service, Department of Medicine, Memorial Sloan Kettering Cancer, New York, New York; Weill Cornell Medicine, New York, New York. Electronic address: markovaa@mskcc.org.
Stephanie J LeeClinical Research Division, Fred Hutchinson Cancer Center, Seattle, Washington; Department of Medicine, University of Washington, Seattle, Washington.
Badri ModiDivision of Dermatology, City of Hope, Duarte, California.
Emily BaumrinDepartment of Dermatology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.
Rachel K RosensteinCenter for Discovery and Innovation and Department of Internal Medicine, Hackensack Meridian School of Medicine, Hackensack University Medical Center, Nutley, New Jersey.
Eric R TkaczykDepartment of Veterans Affairs, Nashville, Tennessee; Department of Dermatology, Vanderbilt University Medical Center, Nashville, Tennessee.
Julia S LehmanDepartments of Dermatology and Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota.
Yoshihiro InamotoDepartment of BMT and Cellular Therapy, Fujita Health University School of Medicine, Toyoake, Aichi, Japan.
Paul A CarpenterClinical Research Division, Fred Hutchinson Cancer Center, Seattle, Washington; Department of Pediatrics, University of Washington, Seattle, Washington.
Kirk R SchultzMichael Cuccione Childhood Cancer Research Program, British Columbia Children's Hospital Research Institute, University of British Columbia, Vancouver, British Columbia, Canada.
Joseph A PidalaDepartment of Blood and Marrow Transplantation and Cellular Immunotherapy, Moffitt Cancer Center, Tampa, Florida.
Paul MartinClinical Research Division, Fred Hutchinson Cancer Center, Seattle, Washington; Department of Medicine, University of Washington, Seattle, Washington.
Iskra PusicDivision of Oncology, Washington University School of Medicine, Siteman Cancer Center, St. Louis, Missouri; Immune Deficiency Cellular Therapy Program, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, Maryland.
Sencer GoklemezImmune Deficiency Cellular Therapy Program, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, Maryland; Division of Hematology Oncology, Department of Internal Medicine, University of Cincinnati Medical Center, Cincinnati, Ohio.
Christian StockmannUniversity of Zurich, Institute of Anatomy, Zurich, Switzerland.
Iago Pinal-FernandezMuscle Disease Section, National Institute of Arthritis and Musculoskeletal and Skin Diseases, National Institutes of Health, Bethesda, Maryland; Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, Maryland.
Sophie PaczesnyHollings Cancer Center and Department of Pharmacology and Immunology, Medical University of South Carolina, Charleston, South Carolina.
Andrew HarrisPediatric Transplant and Cellular Therapies, Memorial Sloan Kettering Cancer Center, New York, New York.
Doris M PonceDepartment of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York; Weill Cornell Medical College, New York, New York.
Noa G HoltzmanDivision of Transplantation and Cell Therapy, Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, Florida.
Najla El JurdiImmune Deficiency Cellular Therapy Program, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, Maryland.
Steven Z PavleticImmune Deficiency Cellular Therapy Program, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, Maryland.
Edward W CowenDermatology Branch, National Institute of Arthritis and Musculoskeletal and Skin Diseases, National Institutes of Health, Bethesda, Maryland.

Funding

X-RAY CRYSTALLOGRAPHYP30CA008748 · NCI · SLOAN-KETTERING INSTITUTE FOR CANCER RES · PI SELWYN M VICKERS · 1985 to 2026
$347.4M
Improving Outcomes Assessment in Chronic GVHDR01CA118953 · NCI · FRED HUTCHINSON CANCER RESEARCH CENTER · PI LEE, STEPHANIE J · 2011 to 2025
$8.3M
UM Calabresi Clinical Oncology Research Career Development AwardK12CA226330 · NCI · UNIVERSITY OF MIAMI SCHOOL OF MEDICINE · PI Alan Pollack · 2018 to 2026
$5.1M
Biologic correlatives of chronic GVHD onsetU01CA236229 · NCI · FRED HUTCHINSON CANCER RESEARCH CENTER · PI LEE, STEPHANIE J · 2019 to 2023
$3.9M
Training and Career Development CoreU54CA163438 · NCI · FRED HUTCHINSON CANCER RESEARCH CENTER · PI LEE, STEPHANIE J · 2011 to 2014
$3.7M
Improving Outcomes Assessment in Chronic GVHDU01CA118953 · NCI · FRED HUTCHINSON CANCER RESEARCH CENTER · PI LEE, STEPHANIE J · 2007 to 2010
$3.1M
Artificial intelligence to estimate extent of cGVHD from patient photosR01HL169944 · NHLBI · VANDERBILT UNIVERSITY MEDICAL CENTER · PI Eric R Tkaczyk · 2024 to 2026
$2.3M
Intestinal microbiome restoration in allogeneic stem cell transplantationR01HL164902 · NHLBI · SLOAN-KETTERING INST CAN RESEARCH · PI Doris Ponce, Marcel R M van den Brink · 2023 to 2026
$1.8M
Development and validation of a patient-reported outcome measure to improve quality of life related to cutaneous chronic GVHDK23AR085191 · NIAMS · UNIVERSITY OF PENNSYLVANIA · PI Emily Baumrin · 2025 to 2026
$348k
CSRD VA I01 CX002721CSRD VA IK2 CX001785NCI NIH HHS K12 CA226330NCI NIH HHS P30 CA008748NCI NIH HHS R01 CA118953NCI NIH HHS U01 CA118953NCI NIH HHS U01 CA236229NCI NIH HHS U54 CA163438NHLBI NIH HHS R01 HL164902NHLBI NIH HHS R01 HL169944NIAMS NIH HHS K23 AR085191
6 · The paper itself

Abstract

The National Institutes of Health (NIH) chronic graft-versus-host disease (cGVHD) Consensus Project established response criteria that enabled clinical trials and facilitated regulatory approval of multiple therapies. Nonetheless, organ-specific assessments have limitations, particularly for severe sclerotic skin involvement. Cutaneous manifestations occur in approximately half of patients with chronic GVHD but are difficult to evaluate due to heterogeneous clinical features. To address these challenges, the NIH Consensus Skin Task Force convened from 2024 to 2025 to refine skin response measures for use in clinical trials. This report (1) summarizes current diagnosis and scoring of skin chronic GVHD, (2) reviews existing response assessments, (3) identifies gaps in their performance, (4) proposes refinements to the 2014 NIH skin response criteria, and (5) outlines future directions incorporating patient-reported outcomes, novel technologies, and biomarker research. Current NIH scoring relies on a 4-point body surface area (BSA) scale and a 3-point sclerosis features scale. While standardized, these measures have limited sensitivity to clinically meaningful change. Proposed refinements include: (1) separate BSA assessments for epidermal involvement and sclerotic features; (2) modification of sclerosis descriptors, with removal of impaired mobility and specification of GVHD-related ulceration, and addition of sclerosis-associated edema with or without erythema; and (3) replacement of the exploratory severity scale with two new clinician instruments. The Sclerosis Quality and Physical Signs scale (0 to 10) captures qualitative physical changes, while the Sclerosis Daily Function Impact scale (0 to 4) evaluates functional compromise. These proposed refinements aim to improve the accuracy, reproducibility, and clinical relevance of skin chronic GVHD assessments, strengthening trial endpoints and patient care.

Indexed as

Graft vs Host DiseaseSkinSkin DiseasesChronic DiseaseHumansNational Institutes of Health (U.S.)United StatesChronic cutaneous GVHDChronic graft-versus-host diseaseChronic GVHD responseEpidermal GVHDSclerotic GVHDSkin GVHD

Identifiers

PMID41539488
PMCPMC12858292

What OpenQuestion holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.