Allogeneic Hematopoietic Cell Transplantation (HCT) is a curative and established treatment approach for patients with haematological malignancies such as leukaemia. However, graft-versus-host disease (GvHD), where the transplanted stem cells react against the tissues of the patient, is a major complication and often results in late morbidity and mortality, as well as in a reduction of quality of life. The accurate evaluation of this disease is thus of paramount importance to correctly evaluate and optimize transplantation outcome.
The transplantation community has made major efforts to develop international guidelines to diagnose and score GvHD accurately. However, it still remains a challenge to effectively implement the guidelines in daily clinical practice, as clinicians tend to consider them to be relatively complex and time consuming1, 2.
Dr Grzegorz Basak, Chair of the EBMT Transplantation Complications Working Party (TCWP) explains: "Our Working Party has been collaborating since 2014 with the University Hospitals Leuven (UZ Leuven) / KU Leuven (Academic Centre for Nursing and Midwifery) and the NIH to develop an electronic tool named 'eGVHD App', to help clinicians achieve optimal evaluation of GvHD. A rigorous user-centered design process has been followed: several rounds of feedback from experts and users have been included to improve usability and accuracy of the App."
The 'eGVHD App' is available on:
- the AppStore - https:/
/ itunes. apple. com/ be/ app/ egvhd/ id1355873791?mt= 8
- GooglePlay https:/
/ play. google. com/ store/ apps/ details?id= be. uzleuven. ghvd
- online at https:/
/(best to be used with a google chrome browser) www. uzleuven. be/ egvhd
It is a user-friendly educational tool, which encourages the healthcare professional to work in a systematic fashion and evaluate all potentially affected organ systems according to up-to-date international guidelines. The app provides the user convenient details, such as definitions and pictures to illustrate the terms used, and segregates information according to the type of evaluation needed: whether aiming at research or daily practice GVHD assessment. Finally, the App gathers the information entered by the healthcare professional and produces the final score automatically, using an internal algorithm.
The use of the eGVHD app has already repeatedly been shown to improve the accuracy of the GVHD assessment of health care professionals2, 3. Right now, it is still limited to an educational function, but CE marking steps are underway, thanks to the support of the HTC Project Endowment Funds recently created by CRYOSTEM, to allow for certification for a broader clinical use.
Dr Helene Schoemans, HCT physician from the University Hospitals Leuven, Belgium explains: "The development of the eGVHD App is a fantastic experience. We have the chance to work with a team of highly motived healthcare professionals and IT specialists across the world. We have translated their expertise and feedback in a computer algorithm using an interactive development strategy to ensure optimal usability and user adoption of the tool." Dr Schoemans adds: "This has resulted in a rich interdisciplinary interaction and stimulating discussions. Ultimately, we hope that the eGVHD App will provide all healthcare professionals with what we could call a 'portable GVHD expert' to assist them in their clinical practice. It's an exciting challenge!"
This project was supported by an educational grant: the 'SOFHEA chair in stem cell transplantation'.