Successful Treatment of Refractory Graft-Versus-Host Disease with Ruxolitinib in a Child after Autologous Stem Cell Transplantation

Autologous hematopoietic stem cell transplantation (AHSCT) is an increasingly used curative treatment for some solid tumors in children. Instead of allogeneic transplantation, the risk of developing graft-versus-host disease (GvHD) is much lower after AHSCT. Although the clinical findings of auto-GV...

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Main Authors: Nurşah Eker, Burcu Tufan Taş, Ömer Doğru, Emel Şenay, Ayşe Gülnur Tokuç, Ahmet Koç
Format: Article
Language:English
Published: Galenos Publishing House 2022-06-01
Series:Journal of Pediatric Research
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Online Access: http://jpedres.org/archives/archive-detail/article-preview/successful-treatment-of-refractory-graft-versus-ho/52013
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author Nurşah Eker
Burcu Tufan Taş
Ömer Doğru
Emel Şenay
Ayşe Gülnur Tokuç
Ahmet Koç
author_facet Nurşah Eker
Burcu Tufan Taş
Ömer Doğru
Emel Şenay
Ayşe Gülnur Tokuç
Ahmet Koç
author_sort Nurşah Eker
collection DOAJ
description Autologous hematopoietic stem cell transplantation (AHSCT) is an increasingly used curative treatment for some solid tumors in children. Instead of allogeneic transplantation, the risk of developing graft-versus-host disease (GvHD) is much lower after AHSCT. Although the clinical findings of auto-GVHD are mild and self-limited in most cases, rare cases may be severe and need intensive immunosuppressive treatment. Here, we present a case who underwent autologous HSCT due to relapsed neuroblastoma, developed steroid-refractory GvHD after AHSCT, and achieved remission using ruxolitinib. A 12 years old female patient was diagnosed with relapsed neuroblastoma. After metaiodobenzylguanidine treatment, AHSCT was performed, and the status of the disease was a very good partial response at the time of transplantation. Our patient was diagnosed with severe and steroid-refractory GvHD with skin involvement after AHSCT. We used ruxolitinib with extracorporeal photopheresis because of the essential side effects of the other drugs and got a very good response. Over the following five months, there was no recurrence of GvHD. She was in complete remission of neuroblastoma after two years of AHSCT. It is crucial to keep in mind that GvHD may develop after AHSCT. Ruxolitinib is an effective treatment for GvHD also after AHSCT. Further studies and case reports are needed to understand the disease’s pathogenesis and regulate appropriate treatment.
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institution Kabale University
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spelling doaj-art-1aff4c70f81a463bb5ff333c6e6f1fad2025-08-20T03:54:23ZengGalenos Publishing HouseJournal of Pediatric Research2147-94452587-24782022-06-019219720010.4274/jpr.galenos.2022.6933513049054Successful Treatment of Refractory Graft-Versus-Host Disease with Ruxolitinib in a Child after Autologous Stem Cell TransplantationNurşah Eker0Burcu Tufan Taş1Ömer Doğru2Emel Şenay3Ayşe Gülnur Tokuç4Ahmet Koç5 Marmara University Faculty of Medicine, Department of Pediatric Hematology Oncology, İstanbul, Turkey Marmara University, Pendik Training and Research Hospital, Clinic of Pediatric Hematology Oncology, İstanbul, Turkey Marmara University Faculty of Medicine, Department of Pediatric Hematology Oncology, İstanbul, Turkey Marmara University, Pendik Training and Research Hospital, Clinic of Pediatric Hematology Oncology, İstanbul, Turkey Marmara University Faculty of Medicine, Department of Pediatric Hematology Oncology, İstanbul, Turkey Marmara University Faculty of Medicine, Department of Pediatric Hematology Oncology, İstanbul, Turkey Autologous hematopoietic stem cell transplantation (AHSCT) is an increasingly used curative treatment for some solid tumors in children. Instead of allogeneic transplantation, the risk of developing graft-versus-host disease (GvHD) is much lower after AHSCT. Although the clinical findings of auto-GVHD are mild and self-limited in most cases, rare cases may be severe and need intensive immunosuppressive treatment. Here, we present a case who underwent autologous HSCT due to relapsed neuroblastoma, developed steroid-refractory GvHD after AHSCT, and achieved remission using ruxolitinib. A 12 years old female patient was diagnosed with relapsed neuroblastoma. After metaiodobenzylguanidine treatment, AHSCT was performed, and the status of the disease was a very good partial response at the time of transplantation. Our patient was diagnosed with severe and steroid-refractory GvHD with skin involvement after AHSCT. We used ruxolitinib with extracorporeal photopheresis because of the essential side effects of the other drugs and got a very good response. Over the following five months, there was no recurrence of GvHD. She was in complete remission of neuroblastoma after two years of AHSCT. It is crucial to keep in mind that GvHD may develop after AHSCT. Ruxolitinib is an effective treatment for GvHD also after AHSCT. Further studies and case reports are needed to understand the disease’s pathogenesis and regulate appropriate treatment. http://jpedres.org/archives/archive-detail/article-preview/successful-treatment-of-refractory-graft-versus-ho/52013 autologous stem cell transplantationchildrengraft versus host diseaseruxolitinibsteroid-resistant
spellingShingle Nurşah Eker
Burcu Tufan Taş
Ömer Doğru
Emel Şenay
Ayşe Gülnur Tokuç
Ahmet Koç
Successful Treatment of Refractory Graft-Versus-Host Disease with Ruxolitinib in a Child after Autologous Stem Cell Transplantation
Journal of Pediatric Research
autologous stem cell transplantation
children
graft versus host disease
ruxolitinib
steroid-resistant
title Successful Treatment of Refractory Graft-Versus-Host Disease with Ruxolitinib in a Child after Autologous Stem Cell Transplantation
title_full Successful Treatment of Refractory Graft-Versus-Host Disease with Ruxolitinib in a Child after Autologous Stem Cell Transplantation
title_fullStr Successful Treatment of Refractory Graft-Versus-Host Disease with Ruxolitinib in a Child after Autologous Stem Cell Transplantation
title_full_unstemmed Successful Treatment of Refractory Graft-Versus-Host Disease with Ruxolitinib in a Child after Autologous Stem Cell Transplantation
title_short Successful Treatment of Refractory Graft-Versus-Host Disease with Ruxolitinib in a Child after Autologous Stem Cell Transplantation
title_sort successful treatment of refractory graft versus host disease with ruxolitinib in a child after autologous stem cell transplantation
topic autologous stem cell transplantation
children
graft versus host disease
ruxolitinib
steroid-resistant
url http://jpedres.org/archives/archive-detail/article-preview/successful-treatment-of-refractory-graft-versus-ho/52013
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