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EBMT 2026 | Insights into the atypical manifestations of chronic GvHD that clinicians should look out for
Daniel Wolff, MD, PhD, University Hospital of Regensburg, Regensburg, Germany, outlines atypical manifestations of chronic graft-versus-host disease (GvHD) that clinicians should be aware of. He highlights that the most detrimental manifestations associated with an increased risk of mortality include vasculitis, polyserositis, and lung manifestations like interstitial lung disease (ILD) and fibrosis. This interview took place at the 52nd Annual Meeting of the EBMT in Madrid, Spain.
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Transcript
The community knows since 40 years that chronic graft-versus-host disease is basically manifesting at every part of the body. It was not really acknowledged in registries. It was not part of the NIH organ grading. And nevertheless, one-fourth of patients develop atypical manifestations. And now the question… and atypical manifestations are kind of diseases which mimic any autoimmune disease you can think of...
The community knows since 40 years that chronic graft-versus-host disease is basically manifesting at every part of the body. It was not really acknowledged in registries. It was not part of the NIH organ grading. And nevertheless, one-fourth of patients develop atypical manifestations. And now the question… and atypical manifestations are kind of diseases which mimic any autoimmune disease you can think of. And the list of potential organs involved is as long as the classic organs, the eight classic organs. Now the question, what manifestations are most detrimental? The one is renal manifestations, especially vasculitis type manifestations with late TMA coming with a high mortality. Polyserositis is an issue which can also limit life expectancy. And there’s another area which was kind of a little bit ignored that was atypical manifestation of the lung with interstitial lung disease and fibrosing disease, which have impaired life expectancy and which was not regarded until recently as part of chronic graft-versus-host disease. So those would be the organs I would worry most about. But having said that, there are other organ manifestations like encephalitis, which significantly impair patients and can be misdiagnosed if not recognized as part of chronic graft-versus-host disease.
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