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Ruxolitinib: a steroid sparing agent in chronic graft-versus-host disease. 2018
Hanna Jean Khoury, and
Amelia A Langston, and
Vamsi K Kota, and
Jennifer A Wilkinson, and
Iskra Pusic, and
Anand Jillella, and
Stephanie Bauer, and
Audrey S Kim, and
Danielle Roberts, and
Zaid Al-Kadhimi, and
Imre Bodo, and
Elliott Winton, and
Martha Arellano, and
John F DiPersio
Department of Hematology and Medical Oncology Winship Cancer Institute of Emory, University Atlanta, Atlanta, GA, USA. hkhoury@emory.edu.
Inhibition of the Janus-associated kinases (JAK) with ruxolitinib (RUX) reduces graft-versus-host disease (GVHD) in preclinical and clinical models. In total 19 allograft recipients with moderate/severe steroid-dependent chronic GVHD received RUX as ≥2nd line salvage. RUX was well tolerated, and led to complete/partial resolution of oral (92/7%), cutaneous (82/0%), hepatic (71/28%), gastro-intestinal (75/17%), musculoskeletal (33/67%), pulmonary (0/80%), scleroderma (0/75%), vaginal (0/75%), and ocular (0/100%) chronic GVHD. Overall 18 achieved partial response and 1 complete response according to NIH Consensus Criteria. Responses occurred early and were sustained which enabled discontinuation (68%) or reduction of steroids to physiologic doses (21%). We conclude that RUX is an effective steroid-sparing agent in chronic GVHD.
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