Symposium | The role of nurses within the multidisciplinary GvHD care team

During the 52nd Annual Meeting of the EBMT, the GvHD Hub held a live symposium on March 24, 2026, titled “Focusing GvHD care through the eyes of providers and patients: Practical insights on ECP”. Here, we share a presentation by Michelle Kenyon, London, UK, describing the role of nurses within the multidisciplinary care of patients with graft-versus-host disease (GvHD).

Kenyon highlights the essential role of nurses in the multidisciplinary management of GvHD, underlining their involvement in continuous patient monitoring and assessment of symptoms, administration of treatment, and management of complications, alongside their integral role in providing education and continuous support to patients and their families. Kenyon also emphasizes the importance of effective communication, noting that nurses act as key facilitators within the multidisciplinary team (MDT) to ensure clear information exchange between patients and the wider healthcare team.

Key points

• Nurses have many roles in GvHD care (Figure 1), playing a central role in supporting patients throughout their treatment journey.

• The role of nurses spans the entire GvHD journey, with distinct yet overlapping responsibilities at different stages of the care pathway. For example:
  • Pre-transplant: Educating patients and preparing them for post-transplant care.
  • Post-transplant: Observing patients at their bedside, monitoring vital signs, and symptom assessment.
  • Acute GvHD (aGvHD): Ensuring prompt recognition and treatment, symptom monitoring and care, timely escalation, infection prevention, and comprehensive patient and family support.
  • Chronic GvHD (cGvHD): Supporting long-term symptom management through ongoing assessments, medication and side-effect monitoring, specialty referrals, patient and family support, and lifestyle and health promotion.
  • Long-term follow-up: Providing support with rehabilitiation and suvivorship share, including routine assessments, lifestyle education, and emotional support.
• Nurses play a key role in the identification of GvHD symptoms and are uniquely positioned at the bedside to detect subtle changes in a patient’s condition. In addition, patients often feel more comfortable reporting new symptoms to nurses due to the trusted relationships they build.
  • These factors facilitate early identification of GvHD, enabling prompt intervention and potential for optimizing patient outcomes.
• Validated tools can be used to facilitate consistent symptom assessment and monitoring during therapy, enabling routine reassessment of disease status and treatment response. 
  • The MAGIC consortium has provided guidelines to standardize the assessment of aGvHD, including criteria for capturing target-organ staging and determining overall clinical grade based on target-organ involvement (Figure 2).²
  • NIH recommendations define cGvHD-specific core measures for diagnosis and assessment of response and symptom burden (Table 1).³

• Kenyon outlined key nursing considerations for administration of ECP therapy (Figure 3).

• Patient education and support are key components of care for patients receiving ECP, and can be delivered through a range of approaches:
  • Explaining the ECP process. For example, by providing visual materials, or describing the procedure in simple steps.
  • Addressing concerns or misconceptions. Concerns may include fear of the unknown, misunderstanding the purpose of treatment, treatment effectiveness, frequency of visits, and travel commitments.
  • Providing support through the long-term commitment of ECP therapy. For example, offering reassurance that the frequency of sessions will usually reduce over time, with treatment response.
• Nurses are essential in enabling a multidisciplinary approach to GvHD care, with several key themes and behaviors underpinning this role:
  • Communication: Acting as facilitators, using standardized handover tools (e.g. Situation, Background, Assessment, and Recommendation [SBAR]), and ensuring frequent updates and clear documentation.
  • Interprofessional collaboration: Fostering a collaborative environment, using assertive and clear communication regarding patient status, and offering support to peers.
  • Advocacy: Ensuring patient advocacy and highlighting the patient voice in care decisions.
  • Being a key worker: Coordinating care plans and ensuring continuity of care.
  • Knowledge sharing: Promoting a team-based culture and supporting education and training for healthcare professionals (HCPs) involved in GvHD care.
• To conclude, Kenyon details several ways to support nurses in delivering care for patients with GvHD (Figure 4).

Q&A

At the end of the presentation, Kenyon responds to a question from the audience, “What are the main challenges you face in ensuring effective communication between patients and the wider healthcare team?”.

• Kenyon stresses the vital role of nurses in patient advocacy, particularly in discussions where patients are not present. She emphasizes that effective advocacy requires an objective understanding of patients’ needs, free from personal assumptions or bias. She also underscores the importance of clear communication through accurate documentation of interactions with patients, ensuring this information is accessible to the wider healthcare team. In addition, she notes the value of nurses being present during difficult conversations with patients, not only to listen, but also to support them in articulating their views.