aGvHD Grading (Glucksberg/MAGIC)

aGvHD Grading: Hierarchical clinical grading based on organ-specific involvement. Grade II–IV usually warrants systemic immunosuppression.

Skin (Rash)

Liver (Bilirubin)

GI (Diarrhea)

Composite Clinical Grade

-

Clinical aGvHD criteria not met based on selected organ stages.

Guidelines & Evidence

Verified

Last Review: 2026-07-17

When to Use

Standardized clinical assessment of patients following hematopoietic cell transplant who develop clinical signs of acute Graft-vs-Host Disease (aGvHD).

To guide treatment decisions (e.g., initiating corticosteroids for Grade ≥ II disease).

Ensuring consistent toxicity reporting in clinical trials.

Patient Population

Patients who have received allogeneic hematopoietic cell transplantation.

Timing

Historically, "acute" GvHD was restricted to within 100 days of HCT. Current consensus (NIH 2014) defines aGvHD by clinical phenotype (e.g., maculopapular rash, secretory diarrhea, cholestatic jaundice), regardless of the time elapsed since transplant.

How it Works

Individual Organ Staging (1 - 4)

Stage	Skin (Rash)	Liver (Bili mg/dL)	GI (Diarrhea)
1	< 25% BSA	2.0 - 3.0	500 - 1000 mL/day
2	25 - 50% BSA	3.1 - 6.0	1001 - 1500 mL/day
3	> 50% BSA	6.1 - 15.0	> 1500 mL/day
4	Bullae/Desquam.	> 15.0	Severe Pain / Ileus

Overall Clinical Grade (I - IV)

Grade	Skin Stage	Liver Stage	GI Stage	Severity
I	1 – 2	0	0	Mild
II	3 OR	1 OR	1	Moderate
III	—	2 – 3 OR	2 – 4	Severe
IV	4 OR	4	—	Life-threatening

Last Comprehensive Review: 2026-07-17

In Recent Clinical News

Scanning Medical Journals

No new significant updates or guidelines matching this topic were found today. We will check again soon.

aGvHD Grading (Glucksberg/MAGIC)

Skin (Rash)

Liver (Bilirubin)

GI (Diarrhea)

-

When to Use

When to Use

Patient Population

Timing

How it Works

Individual Organ Staging (1 - 4)

Overall Clinical Grade (I - IV)

Clinical Pearls

BSA Estimators

Bowel Output in Pediatrics

The Evidence

Primary Score

Clinical manifestations of graft-versus-host disease in human recipients of marrow from HL-A-matched sibling donors.

International, Multicenter Standardization of Acute Graft-versus-Host Disease Clinical Data Collection: A Report from the MAGIC Consortium.

Origins & History

Legacy

In Recent Clinical News

aGvHD Grading (Glucksberg/MAGIC)

Skin (Rash)

Liver (Bilirubin)

GI (Diarrhea)

-

When to Use

When to Use

Patient Population

Timing

How it Works

Individual Organ Staging (1 - 4)

Overall Clinical Grade (I - IV)

Clinical Pearls

BSA Estimators

Bowel Output in Pediatrics

The Evidence

Primary Score

Clinical manifestations of graft-versus-host disease in human recipients of marrow from HL-A-matched sibling donors.

International, Multicenter Standardization of Acute Graft-versus-Host Disease Clinical Data Collection: A Report from the MAGIC Consortium.

Origins & History

Legacy

In Recent Clinical News