|Videos|April 7, 2022

Case Commentary and Considerations for Treatment and Management

Author(s)Pashna Munshi, MD

A commentary on the patient’s case and strategies for treatment selection and management for those with steroid-refractory disease.

Episodes in this series

$EP. 1 Introduction: A 58-Year-Old Man With Moderate Steroid-Refractory cGVHD and Risk Factors for cGVHD$

EP. 1 Introduction: A 58-Year-Old Man With Moderate Steroid-Refractory cGVHD and Risk Factors for cGVHD

EP. 2 Overview of cGVHD Symptoms, Diagnosis, and Tools for Severity Assessment

EP. 2 Overview of cGVHD Symptoms, Diagnosis, and Tools for Severity Assessment

$EP. 3 Steroid-Refractory cGVHD: Risk Factors and Clinical Challenges$

EP. 3 Steroid-Refractory cGVHD: Risk Factors and Clinical Challenges

$EP. 4 Treatment Options for Steroid-Refractory cGVHD$

EP. 4 Treatment Options for Steroid-Refractory cGVHD

$EP. 5 Ruxolitinib in Steroid-Refractory cGVHD and REACH3 Efficacy Data$

EP. 5 Ruxolitinib in Steroid-Refractory cGVHD and REACH3 Efficacy Data

$EP. 6 Real-World Efficacy Data for Ruxolitinib in Steroid-Refractory cGVHD$

EP. 6 Real-World Efficacy Data for Ruxolitinib in Steroid-Refractory cGVHD

EP. 7 Ruxolitinib Adverse Event Data and Strategies for Managing Side Effects

EP. 7 Ruxolitinib Adverse Event Data and Strategies for Managing Side Effects

EP. 8 Case Commentary and Considerations for Treatment and Management

EP. 8 Case Commentary and Considerations for Treatment and Management

EP. 9 Future Directions in GVHD

EP. 9 Future Directions in GVHD

Case: A 58-Year-Old Man With Moderate Steroid-Refractory Chronic Graft-Versus-Host Disease

Initial Presentation

A 58-year-old man previously underwent myeloablative conditioning and an allogeneic PBSC transplant for acute lymphocytic leukemia
Received tacrolimus and methotrexate for GVHD prophylaxis
At 10 months post-transplant, patient developed moderate muscle and joint pain with decreased range of motion, mild erythematous rash on cheeks

First-line Treatment

Patient received topical steroid cream for rash, and was started on oral prednisone at 1 mg/kg/day
After 4 weeks of treatment, the patient’s rash resolved but muscle/joint pain continued

Second-line Treatment

Patient is now receiving ruxolitinib 10 mg orally twice daily, alongside 1 mg/kg/day steroids

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