Table 1.

GVHD Target Organ Staging

Stage	Skin (active erythema only)	Liver (bilirubin)	Upper GI	Lower GI (stool output/day)
0	No active (erythematous) GVHD rash	< 2 mg/dl	No or intermittent nausea, vomiting or anorexia	Adult: < 500 ml/day or <3 episodes/day Child: < 10 ml/kg/day or <4 episodes/day
1	Maculopapular rash <25% BSA	2–3 mg/dl	Persistent nausea, vomiting or anorexia	Adult: 500–999 ml/day or 3–4 episodes/day Child: 10–19.9 ml/kg/day or 4–6 episodes/day
2	Maculopapular rash 25 – 50% BSA	3.1–6 mg/dl	-	Adult: 1000–1500 ml/day or 5–7 episodes/day Child: 20 – 30 ml/kg/day or 7–10 episodes/day
3	Maculopapular rash > 50% BSA	6.1–15 mg/dl	-	Adult: >1500 ml/day or >7 episodes/day Child: > 30 ml/kg/day or >10 episodes/day
4	Generalized erythroderma (>50% BSA) plus bullous formation and desquamation > 5% BSA	>15 mg/dl	-	Severe abdominal pain with or without ileus, or grossly bloody stool (regardless of stool volume).

Overall clinical grade (based upon most severe target organ involvement):

• Grade 0: No stage 1–4 of any organ
• Grade I: Stage 1–2 skin without liver, upper GI or lower GI involvement
• Grade II: Stage 3 rash and/or stage 1 liver and/or stage 1 upper GI and/or stage 1 lower GI
• Grade III: Stage 2–3 liver and/or stage 2–3 lower GI, with stage 0–3 skin and/or stage 0–1 upper GI
• Grade IV: Stage 4 skin, liver or lower GI involvement, with stage 0–1 upper GI