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