Treatment Options for Steroid-Refractory Chronic GVHD
Yi-Bin Chen, MD, discusses available treatment options for patients with steroid-refractory chronic GVHD.
EP: 1.Overview: A 42-Year-Old Woman With Moderate Steroid-Refractory Chronic GVHD
EP: 2.Risk Factors for Chronic GVHD and Steroid-Refractory Disease
EP: 3.Symptoms and Manifestations of Chronic GVHD
EP: 4.Early Diagnosis of Chronic GVHD and Tools for Severity Assessment
EP: 5.Treatment Options for Steroid-Refractory Chronic GVHD
EP: 6.Ruxolitinib Efficacy in Steroid-Refractory Chronic GVHD
EP: 7.Ruxolitinib Safety in Steroid-Refractory Chronic GVHD
EP: 8.Reflections on the Case and Risk Management for Chronic GVHD
EP: 9.Steroid-Refractory Chronic GVHD: Unmet Needs and Future Directions
Case: A 42-Year-Old Woman With Moderate Steroid-Refractory Chronic Graft-Versus-Host Disease
Initial Presentation
- A 42-year-old woman previously underwent myeloablative conditioning and an allogeneic PBSC transplant for acute myeloid leukemia
- Received tacrolimus and methotrexate for GVHD prophylaxis
- At 11 months post-transplant, patient developed moderately dry and painful eyes, mild muscle and joint pain, mild erythematous rash on face and arms
First-line Treatment
- Patient received eye drops, topical steroid cream for rash, and was started on oral prednisone at 0.5 mg/kg/day
- After 4 weeks of treatment, eye dryness resolved, but the patient’s skin rash and muscle/joint pain worsened; steroid dose was increased to 1 mg/kg/day
- Skin rash and muscle/joint pain continued despite increased steroid dose
Second-line Treatment
Patient is now receiving ruxolitinib 10 mg orally twice daily, alongside 1 mg/kg/day steroids
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