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Persistent Gastrointestinal GVHD: The Application and Utility of Histologic Grading Schemes

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Abstract

Prolonged GVHD is a major cause of morbidity and mortality. The damages are not uniform for different regions of the gut. Previous grading methods using the Lerner-Sale scheme have not been useful at predicting outcome at early stages. However, more recent studies indicate involvement of the lower gut, with Lerner-Sale grade I portending a worse outcome. The Myerson apoptotic activitiy index, a second grading scheme which quantitiates the range of apoptotic bodies within Lerner-Sale grade I, provides useful information for guiding therapeutic intervention. The spectrum of gut GVHD, from a single apoptosis to diffuse intestinal ulceration, is presented along with the therapeutic implications.

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Author information

Authors and Affiliations

  1. Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA

    Howard M. Shulman, David W. Woolston & David Myerson

  2. Department of Pathology, University of Washington School of Medicine, Seattle, WA, USA

    Howard M. Shulman & David Myerson

  3. Pathology Section, Seattle Cancer Care Alliance, Seattle, WA, USA

    Howard M. Shulman & David Myerson

Authors
  1. Howard M. Shulman
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  2. David W. Woolston
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  3. David Myerson
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Corresponding author

Correspondence to Howard M. Shulman .

Editor information

Editors and Affiliations

  1. Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA

    Cecilia C. S. Yeung

  2. Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA

    Howard M. Shulman

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Shulman, H.M., Woolston, D.W., Myerson, D. (2019). Persistent Gastrointestinal GVHD: The Application and Utility of Histologic Grading Schemes. In: Yeung, C., Shulman, H. (eds) Pathology of Graft vs. Host Disease. Springer, Cham. https://doi.org/10.1007/978-3-319-42099-8_9

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  • DOI: https://doi.org/10.1007/978-3-319-42099-8_9

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-42098-1

  • Online ISBN: 978-3-319-42099-8

  • eBook Packages: MedicineMedicine (R0)

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