Efficacy and feasibility of ruxolitinib in chronic steroid-refractory GVHD in a pediatric intestine transplant

Shahira Ghobrial*, Corina Gonzalez, Nada Yazigi, Stuart Kaufman, Cal Matsumoto, Thomas Fishbein, Jason Hawksworth, Alexander Kroemer, Khalid Khan

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

8 Scopus citations

Abstract

Acute graft-versus-host disease (GvHD) has been a clinical problem in solid organ transplant that includes intestine due to the donor lymphoid tissue mass which accompanies the intestinal component of the graft. We report a case that demonstrated the efficacy and feasibility of ruxolitinib a JAK 1/2 inhibitor in the treatment of chronic steroid-refractory GVHD (SR-GVHD). The child developed SR-GVHD following a composite intestine transplant (small bowel, colon, liver, and pancreas). And after receiving ruxolitinib 1.25 mg (0.15 mg/kg/dose) per gastric tube (G-tube) daily, the child appeared to have improved skin rash and sigmoidoscopy was negative. Nonetheless, we encourage close monitoring of hematologic and infectious adverse effect during dose escalation, and individualizing patient maximum effective dose with the least adverse effect possible. We stress the importance of early diagnosis and hyper-alertness of GVHD in intestinal transplant patients.

Original languageEnglish
Article numbere13836
JournalPediatric Transplantation
Volume25
Issue number3
DOIs
StatePublished - May 2021
Externally publishedYes

Keywords

  • children
  • graft versus host disease
  • intestine
  • multivisceral
  • pediatric
  • ruxolitinib

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