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Immunosuppressants/ruxolitinib Lack of efficacy: case report A 69-year-old man exhibited lack of efficacy during treatment with ruxolitinib, cyclophosphamide, tacrolimus, mycophenolate mofetil, prednisolone and antithymocyte globulin for GVHD prophylaxis or for treatment of idiopathic pneumonia syndrome [not all dosages and routes stated]. The man, who had acute myeloid leukaemia and had undergone allo-stem cell transplantation 3 months prior, was admitted to a hospital due to dyspnoea during regular follow-up in July 2020. The condition regimen included busulfan, fludarabine and total body irradiation. The GVHD prophylaxis regimen comprised of cyclophosphamide 50 mg/kg on days 3 and 4 and mycophenolate mofetil plus continuous IV tacrolimus from day 5. To reduce the risk of cyclophosphamide-induced cardiomyopathy and the risk of relapse, the dose of cyclophosphamide was reduced from 50 mg/kg for 2 days. On day 17 after the transplantation, he developed bacterial pneumonia on day 17. but the symptoms resolved following the engraftment. On day 27, he developed skin erythema and dry cough. Based on skin biopsy findings, he was diagnosed with grade II cute GVHD, despite receiving proph

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Publisher

Springer Science and Business Media LLC

Published

2023

Language

EN

Field

Medicine (Health Sciences)