NIH Consensus Task Force: Refined response criteria for cutaneous cGvHD

Refined response assessment criteria for cutaneous chronic graft-versus-host disease (cGvHD) from the National Institutes of Health (NIH) Consensus Project Skin Task Force were published in Transplantation and Cellular Therapy by Markova et al. Cutaneous manifestations present in approximately 50% of patients with cGvHD; however, they are difficult to evaluate due to heterogeneous features. The task force convened in 2024–2025 to address these limitations and refine skin response measures for use in clinical trials.

Key data: Proposed refinements include the addition of separate body surface area (BSA) assessments for epidermal involvement and sclerotic features; the modification of sclerosis descriptors, including the removal of “impaired mobility”, the modification of “ulceration” to “graft-versus-host disease (GvHD)-related ulceration”, and the addition of “sclerosis-associated edema ± erythema”; and the measurement of sclerosis severity using the new Sclerosis Quality and Physical Signs (SQPS) scale (0–10) and the Sclerosis Daily Function Impact (SDFI) scale (0–4). Modifications to the cutaneous cGvHD overall response (OR) determination to calculate individual responses for epidermal and sclerotic GvHD were also proposed.

Key learning: The proposed refinements aim to improve the accuracy, reproducibility, and clinical relevance of skin cGvHD assessments. By aligning response measures with patient symptoms and functional outcomes, this framework strengthens trial endpoints and patient-centered care.