National Institutes of Health Consensus Development Project on Criteria for Clinical Trials in Chronic Graft-versus-Host Disease: VI. The 2014 Clinical Trial Design Working Group Report  Paul J. Martin, Stephanie J. Lee, Donna Przepiorka, Mary M. Horowitz, John Koreth, Georgia B. Vogelsang, Irwin Walker, Paul A. Carpenter, Linda M. Griffith, Gorgun Akpek, Mohamad Mohty, Daniel Wolff, Steven Z. Pavletic, Corey S. Cutler  Biology of Blood and Marrow Transplantation  Volume 21, Issue 8, Pages 1343-1359 (August 2015) DOI: 10.1016/j.bbmt.2015.05.004 Copyright © 2015 American Society for Blood and Marrow Transplantation Terms and Conditions

Figure 1 Appropriate management of chronic GVHD requires continuous recalibration of immunosuppressive treatment to avoid over- or under-treatment. The intensity of treatment required to control the disease decreases across time. Manifestations of chronic GVHD improve or are absent when the intensity of treatment (- - -) is above the threshold (shown as the orange curve) and worsen or recur when the intensity of treatment is below the threshold. The slope of the threshold varies among patients and can be determined only by serial attempts to decrease the intensity of treatment. Successful management of chronic GVHD can control the disease until systemic treatment is no longer needed to prevent recurrent or progressive disease activity or exacerbation of any residual damage (.......). Biology of Blood and Marrow Transplantation 2015 21, 1343-1359DOI: (10.1016/j.bbmt.2015.05.004) Copyright © 2015 American Society for Blood and Marrow Transplantation Terms and Conditions