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Back| Grade | Skin (Rash) | Liver (Bilirubin) | Gastrointestinal (Diarrhea) |
|---|---|---|---|
| 0 | No rash | <34μmol/L（<2.0mg/dL） | No diarrhea (or <500ml/d) |
| + | Maculopapular rash <25% body surface area | 34-50μmol/L（2.0-3.0mg/dL） | Diarrhea 500~1000ml/d |
| ++ | Maculopapular rash 25-50% body surface area | 51-102μmol/L（3.1-6.0mg/dL） | Diarrhea 1000~1500ml/d |
| +++ | Extensive skin lesions | 103-255μmol/L（6.1-13.2mg/dL） | Diarrhea >1500ml/d |
| ++++ | Exfoliative dermatitis with blistering | >255μmol/L（>13.2mg/dL） | Severe abdominal pain with or without intestinal obstruction, bloody stools |
| Total GVHD Grade | Skin | Liver | Gastrointestinal | General Condition |
|---|---|---|---|---|
| Ⅰ | +~++ | 0 | 0 | Normal |
| Ⅱ | +~+++ | + | + | Mild decline |
| Ⅲ | ++~+++ | ++~+++ | ++~+++ | Moderate decline |
| Ⅳ | ++~++++ | ++~++++ | ++~++++ | Severe decline |
Explanation
Grade I is mild GVHD, Grade II is moderate GVHD, and Grades III-IV are severe GVHD, which are significantly related to mortality.
The Glucksberg grading system and the IBMTR grading system for acute GVHD have their own advantages in assessing prognosis.
