Consensus diagnostic histopathological criteria for acute gastrointestinal graft versus host disease improve interobserver reproducibility.

Journal Article (Journal Article)

Graft versus host disease (GvHD) is a clinically important complication after allogeneic hematopoietic stem cell transplantation (HSCT). Its diagnosis relies on clinical and histopathological findings. In order to evaluate and improve inter-institutional diagnostic agreement on histological diagnosis and grading of acute gastrointestinal GvHD, we conducted a round robin test, which included 33 biopsies from 23 patients after HSCT. Five pathologists from different institutions independently evaluated the original sections from the biopsies submitted for diagnosis. Based on their results, consensus qualitative criteria for the assessment of typical histological features of GvHD (e.g., apoptosis, crypt destruction, mucosa denudation) were proposed, including detailed descriptions as well as histological images. In a second round robin test with involvement of the same pathologists, the reproducibility of both diagnosis and grading had improved. Remaining differences were mostly related to differential diagnostic considerations, including viral infection or toxic side effects of medication, which should be resolved by integrating histopathological findings with proper clinical information.

Full Text

Duke Authors

Cited Authors

  • Kreft, A; Mottok, A; Mesteri, I; Cardona, DM; Janin, A; Kühl, AA; Andrulis, M; Brunner, A; Shulman, HM; Negri, G; Tzankov, A; Huber, E; Gastrointestinal Pathology Group of the German-Austrian-Swiss GvHD Consortium,

Published Date

  • September 2015

Published In

Volume / Issue

  • 467 / 3

Start / End Page

  • 255 - 263

PubMed ID

  • 26164839

Electronic International Standard Serial Number (EISSN)

  • 1432-2307

Digital Object Identifier (DOI)

  • 10.1007/s00428-015-1803-y


  • eng

Conference Location

  • Germany