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.
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: 3.Steroid-Refractory cGVHD: Risk Factors and Clinical Challenges
EP: 4.Treatment Options for Steroid-Refractory cGVHD
EP: 5.Ruxolitinib in Steroid-Refractory cGVHD and REACH3 Efficacy Data
EP: 6.Real-World Efficacy Data for Ruxolitinib in Steroid-Refractory cGVHD
EP: 7.Ruxolitinib Adverse Event Data and Strategies for Managing Side Effects
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EP: 8.Case Commentary and Considerations for Treatment and Management
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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