Clinical Experience with Ruxolitinib for cGVHD


Experienced hematologist-oncologists offer their clinical experiences with ruxolitinib.


Yi-Bin Chen, MD: So, Colleen, we use a lot of ruxolitinib [at] Mass General [Massachusetts General Hospital] for graft-vs-host disease. What's your experience and perception of it? Has it improved the care for our patients in general?

Collen Danielson, NP: I definitely think it has. It's been a huge benefit to have another agent that we can use, as we're saying, beyond our steroids. It's really well tolerated, for the most part, for our patients. I think what we've seen that's already been commented on is the impact on blood counts. And, so, we're obviously watching that closely. We particularly see anemia being the biggest impact in change in blood counts, and some people experience some change in their platelets and some patients have some fatigue with ruxolitinib. We have had to dose reduce in patients. We obviously try to start at that 10 milligrams bid [twice a day], and dose reduce when we need to. But I think it's shown to be well tolerated and we see benefit from it. We're able to get people off of steroids, certainly quicker than we would without ruxolitinib, and some people have a really great response to it as well. I think when we have people on it a long time, it's been a question of how long do we keep them on it? How do we taper off? But it's really been a huge benefit for our patients.

Yi-Bin Chen, MD:And I'll add the flip side to that question, Corey, and Catherine, either one, we all use ruxolitinib because it has helped our patients, but where is it lacking? So, where is the unmet need, then?

Corey S. Cutler, MD, MPH, FRCPC: Well, I think… [CROSSTALK] Go ahead, please.

Catherine J. Lee, MD, MS: I also feel that, overall, I've seen improvement with ruxolitinib. I haven't had as much CRs as I would like, but I think these are difficult-to-treat organs, which, such as sclerotic GVHD or horrible ocular GVHD. I think ocular GVHD is still one very difficult organ to treat successfully. And, as well, patients with BOS [bronchiolitis obliterans syndrome], I've seen improvement, definitely improvements. But I don't think I've encountered as many home runs as I would like.

Yi-Bin Chen, MD: So, certainly, in advance, but I think many patients and providers are still left wanting more to help our patients.

Transcript is AI-generated and edited for clarity and readability.

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Yi-Bin Chen, MD, an expert on GVHD
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