Severe COVID-19 in a patient with chronic graft-versus-host disease after hematopoietic stem cell transplant successfully treated with ruxolitinib

Transpl Infect Dis. 2021 Feb;23(1):e13401. doi: 10.1111/tid.13401. Epub 2020 Jul 14.

Abstract

Graft-versus-host disease (GVHD) is a common complication of hematopoietic stem cell transplant, which is known to be mediated by cytotoxic T-cell effectors and dysregulated inflammatory cytokines. Similarly, the lung injury observed in severe COVID-19 cases appears to be related to a massive production of pro-inflammatory cytokines. The selective JAK1/2 inhibitor ruxolitinib has shown promising results in the context of GVHD, and different trials are currently underway in patients with severe COVID-19; nevertheless, no clinical observation of safety or efficacy of treatment with ruxolitinib in this context has been published yet. We describe a first case of severe COVID-19 developed after hematopoietic stem cell transplantation in a patient with a concomitant chronic GVHD (cGVHD), in which a treatment with ruxolitinib was administered with good tolerance and positive outcome.

Keywords: ARDS (acute respiratory distress syndrome); COVID-19; chronic graft-versus-host disease (cGVHD); hematopoietic stem cell transplant (SCT); ruxolitinib.

Publication types

  • Case Reports

MeSH terms

  • COVID-19 / complications*
  • COVID-19 / pathology*
  • Graft vs Host Disease / complications*
  • Hematopoietic Stem Cell Transplantation / adverse effects*
  • Humans
  • Male
  • Middle Aged
  • Nitriles
  • Pyrazoles / therapeutic use*
  • Pyrimidines
  • SARS-CoV-2

Substances

  • Nitriles
  • Pyrazoles
  • Pyrimidines
  • ruxolitinib