Diagnosing Acute Graft-Versus-Host Disease in Children Undergoing Hematopoietic Stem Cell Transplantation-Comparison of the Modified Glucksberg Criteria Versus the MAGIC Criteria

Diagnosing acute graft-versus-host disease (aGvHD) following allogeneic hematopoietic stem cell transplantation (HSCT) is challenging due to heterogeneity in interpreting current clinical criteria. Recently, the Mount Sinai Acute GvHD International Consortium (MAGIC) criteria were introduced to improve diagnostic consistency. In a study of 117 pediatric patients undergoing HSCT, the modified Glucksberg and the MAGIC criteria were retrospectively compared. The MAGIC criteria identified significantly more cases of gastrointestinal (GI) aGvHD and increased overall severity, important for guiding systemic treatment. Diagnosing upper GI aGvHD based solely on symptomatology (MAGIC) proved difficult, suggesting a need for stricter definitions. For lower GI aGvHD, the modifications were clearly beneficial, although diarrhea duration remains unspecified.