Long-Term Use of Ruxolitinib in an AML Patient with Posttransplant Steroid Refractory GVHD

Ruxolitinib has become a new therapeutic option for steroid refractory graft-versus-host disease (srGVHD), with a substantial remission rate. Its anti-inflammatory properties by blocking interleukin pathways have made it a novel therapeutic approach to inflammatory disease processes, such as GVHD. T...

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Main Authors: Philip T. Sobash, Achuta K. Guddati, Vamsi Kota
Format: Article
Language:English
Published: Wiley 2020-01-01
Series:Case Reports in Oncological Medicine
Online Access:http://dx.doi.org/10.1155/2020/4936846
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author Philip T. Sobash
Achuta K. Guddati
Vamsi Kota
author_facet Philip T. Sobash
Achuta K. Guddati
Vamsi Kota
author_sort Philip T. Sobash
collection DOAJ
description Ruxolitinib has become a new therapeutic option for steroid refractory graft-versus-host disease (srGVHD), with a substantial remission rate. Its anti-inflammatory properties by blocking interleukin pathways have made it a novel therapeutic approach to inflammatory disease processes, such as GVHD. The long-term use of ruxolitinib has not been explicitly studied outside the context in the treatment of multiple myeloma. With current clinical trials underway for the use of ruxolitinib in srGVHD, there are still no current guidelines or protocols for long-term clinical use. Of the available literature showing ruxolitinib utilization for srGVHD, most cases lead to resolution and eventual discontinuation. We present a case of a 32-year-old male on ruxolitinib with GVHD status postmatched unrelated donor stem cell transplant (MUD SCT) for acute myeloid leukemia (AML) with FLT3 mutation currently on ruxolitinib for 5 years who is not able to tolerate reduction in dosage due to flare-ups. We discuss the clinical implications and nuance of therapy with ruxolitinib with unknown long-term effects and weigh the risks and benefits.
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spelling doaj-art-c5bbcba8d9d945fcb3de66725250c6242025-02-03T06:06:45ZengWileyCase Reports in Oncological Medicine2090-67062090-67142020-01-01202010.1155/2020/49368464936846Long-Term Use of Ruxolitinib in an AML Patient with Posttransplant Steroid Refractory GVHDPhilip T. Sobash0Achuta K. Guddati1Vamsi Kota2Internal Medicine, White River Health System, Batesville, AR, USAMedical Oncology, Augusta University, Augusta, GA, USAMedical Oncology, Augusta University, Augusta, GA, USARuxolitinib has become a new therapeutic option for steroid refractory graft-versus-host disease (srGVHD), with a substantial remission rate. Its anti-inflammatory properties by blocking interleukin pathways have made it a novel therapeutic approach to inflammatory disease processes, such as GVHD. The long-term use of ruxolitinib has not been explicitly studied outside the context in the treatment of multiple myeloma. With current clinical trials underway for the use of ruxolitinib in srGVHD, there are still no current guidelines or protocols for long-term clinical use. Of the available literature showing ruxolitinib utilization for srGVHD, most cases lead to resolution and eventual discontinuation. We present a case of a 32-year-old male on ruxolitinib with GVHD status postmatched unrelated donor stem cell transplant (MUD SCT) for acute myeloid leukemia (AML) with FLT3 mutation currently on ruxolitinib for 5 years who is not able to tolerate reduction in dosage due to flare-ups. We discuss the clinical implications and nuance of therapy with ruxolitinib with unknown long-term effects and weigh the risks and benefits.http://dx.doi.org/10.1155/2020/4936846
spellingShingle Philip T. Sobash
Achuta K. Guddati
Vamsi Kota
Long-Term Use of Ruxolitinib in an AML Patient with Posttransplant Steroid Refractory GVHD
Case Reports in Oncological Medicine
title Long-Term Use of Ruxolitinib in an AML Patient with Posttransplant Steroid Refractory GVHD
title_full Long-Term Use of Ruxolitinib in an AML Patient with Posttransplant Steroid Refractory GVHD
title_fullStr Long-Term Use of Ruxolitinib in an AML Patient with Posttransplant Steroid Refractory GVHD
title_full_unstemmed Long-Term Use of Ruxolitinib in an AML Patient with Posttransplant Steroid Refractory GVHD
title_short Long-Term Use of Ruxolitinib in an AML Patient with Posttransplant Steroid Refractory GVHD
title_sort long term use of ruxolitinib in an aml patient with posttransplant steroid refractory gvhd
url http://dx.doi.org/10.1155/2020/4936846
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