January 2026 Pediatric Lecture Series: Pediatric GVHD and the Role of a Pediatric Physiatrist-Session Recording

Video Transcription

Video Summary

Dr. Kelly Chaviano presented a comprehensive lecture on graft versus host disease (GVHD) in pediatric cancer rehabilitation, focusing on diagnosis, differentiation between acute and chronic GVHD, and recent literature. GVHD, triggered by allogeneic stem cell transplants, mainly affects rapidly dividing tissues like skin, liver, and GI tract. Risk factors include prior acute GVHD, donor-recipient HLA mismatch, and patient age, with disparities more common in diverse populations. She detailed diagnostic criteria, grading scales incorporating functional assessments (ECOG, Karnovsky, Lansky), and discussed treatment and prophylaxis options including steroids, methotrexate, and calcineurin inhibitors. Dr. Chaviano emphasized the rehabilitation perspective, highlighting impairments, activity limitations, and participation restrictions caused by both the disease and its treatments. She advocated for multidisciplinary approaches incorporating PT, OT, speech therapy, and osteopathic manipulative medicine. Emerging research from the RESILIENT conference underscores the need for pediatric-focused rehabilitation frameworks. The talk concluded with practical discussions on early integration of rehab in transplant care and individualized interventions, including cautious use of Botox for function improvement.

Keywords

Graft versus host disease

Pediatric cancer rehabilitation

Acute and chronic GVHD

Stem cell transplant complications

Multidisciplinary rehabilitation

Functional assessment scales