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Case Reports
. 2021 Feb;23(1):e13401.
doi: 10.1111/tid.13401. Epub 2020 Jul 14.

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

Francesco Saraceni  1 , Ilaria Scortechini  1 , Giorgia Mancini  1 , Marianna Mariani  1 , Irene Federici  1 , Mariana Gaetani  2 , Paolo Barbatelli  2 , Maria Luisa Minnucci  2 , Patrizia Bagnarelli  3 , Attilio Olivieri  1
Affiliations
Case Reports

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

Francesco Saraceni et al. Transpl Infect Dis. 2021 Feb.

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.

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Conflict of interest statement

Olivieri A received honoraria as consultant from Novartis in 2017 and 2018. The other authors declare no conflict of interest.

Figures

FIGURE 1
FIGURE 1
Computed tomography scan of the chest performed the day before initiation of treatment with ruxolitinib
FIGURE 2
FIGURE 2
Trend of PaO2/FiO2 ratio and treatment received during hospital stay. Abbreviations: ARDS, acute respiratory distress syndrome; LMWH, low‐molecular‐weight heparin
See this image and copyright information in PMC

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