Effect of ruxolitinib on the oral mucosa of patients with steroid-refractory chronic Graft-versus-Host disease and oral involvement

Kaurinovic, Martina; Delli, Konstantina; Jonk, Ana-Mae E; Biswana, Anouschka; Hazenberg, Carin; Choi, Goda; Groot, Marco R. de; Morsink, Linde M.; Vissink, Arjan; Bellido, Mar

doi:10.1007/s00784-022-04393-1

Cited by 5 publications

(3 citation statements)

References 36 publications

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“…Ruxolitinib, the oral JAK 1/2 inhibitor, was the first JAKi approved for use in myelofibrosis by the US Food and Drug Administration (FDA) and European Medicines Agency (EMA) in 2011. Currently, it is used as salvage therapy for SR-GVHD, especially in cases with BO and oral involvement ( 11 , 12 ).…”

Section: Discussionmentioning

confidence: 99%

Ruxolitinib, a JAK1/2 Inhibitor as Treatment for Paraneoplastic Pemphigus: A Case Report

Fan¹,

Wang

2022

Acta Derm Venereol

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Section: Discussionmentioning

confidence: 99%

Ruxolitinib, a JAK1/2 Inhibitor as Treatment for Paraneoplastic Pemphigus: A Case Report

Fan¹,

Wang

2022

Acta Derm Venereol

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“…All three (Ibrutinib, Ruxolitinib, Belumosudil) belong to the family of kinase inhibitors and are authorized as second- or third-line treatments for cGVHD ( 169 ). Indeed, in an era of personalized medicine, these state-of-the-art immunobiological approaches have demonstrated significant interventional responses for the treatment of oral lichenoid and proliferative lesions, in particular Ruxolitnib ( 134 , 170 , 171 ).…”

Section: Oral Cgvhd Management and Treatment Optionsmentioning

confidence: 99%

Perspectives on oral chronic graft-versus-host disease from immunobiology to morbid diagnoses

2023

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Chronic Graft-versus-Host Disease (cGVHD) is a major long-term complication, associated with morbidity and mortality in patients following allogenic hematopoietic cell transplantation (HCT) for immune hematopoietic disorders. The mouth is one of the most frequently affected organs after HCT (45-83%) and oral cGVHD, which may appear as the first visible sign. Manifestations present with mucosal lichenoid lesions, salivary gland dysfunction and limited oral aperture. Diagnosis of oral cGVHD severity is based on mucosal lesions with symptoms of sensitivity and pain and reduced oral intake. However, diagnostic difficulties arise due to subjective definitions and low specificity to cover the spectrum of oral cGVHD. In recent years there have been significant improvements in our understanding of the underlying oral cGVHD disease mechanisms. Drawing upon the current knowledge on the pathophysiology and biological phases of oral cGVHD, we address oral mucosa lichenoid and Sjogren’s Syndrome-like sicca syndromes. We consider the response of alloreactive T-cells and macrophages to recipient tissues to drive the pathophysiological reactions and biological phases of acute inflammation (phase 1), chronic inflammation and dysregulated immunity (phase 2), and subsequent aberrant fibrotic healing (phase 3), which in time may be associated with an increased malignant transformation rate. When formulating treatment strategies, the pathophysiological spectrum of cGVHD is patient dependent and not every patient may progress chronologically through the biological stages. As such there remains a need to address and clarify personalized diagnostics and management to improve treatment descriptions. Within this review, we highlight the current state of the art knowledge on oral cGVHD pathophysiology and biological phases. We address knowledge gaps of oral cGVHD, with a view to facilitate clinical management and improve research quality on lichenoid biology and morbid forms of oral cGVHD.

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“…However further studies with larger group of patients will be necessary (57). In recent years, the combination therapy of the Janus kinase inhibitor ruxolitinib and ECP is reported very successful (58,59).…”

Section: Graft-versus-host Disease (Gvhd)mentioning

confidence: 99%

Therapeutic Apheresis, Immunosuppression and Human Monoclonal Anti-bodies in Hematologic diseases most with im-munologic origin

Bambauer

Schiel²,

Salgado³

2022

MRAJ

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Therapeutic plasma exchange with hollow fiber modules has been used in different severe diseases for more than 45 years. Updated information on molecular biology and immunology of different diseases, the authors discuss in relation to the rationale for apheresis therapy and its place in combination with other modern therapies such as immunosuppressive drugs, cytotoxic agents, and/or human monoclonal antibodies, With the introduction of novel and effective biologic agents, therapeutic apheresis is indicated in severe cases, such as in rapid progression despite immunosuppressive therapy and/or biologic agents. In mild forms of immunologic diseases, treatment with immunosuppressive therapies and/or biologic agents seems to be sufficient. The prognosis of hematologic diseases has improved in recent years, due in part to very aggressive therapy schemes. For the hematologic diseases, especially diseases with an immunologic origin, such as various anemias, erythrocytosis, theombocytopenia, hyperleukocytosis and coagulation inhibitors that can be treated with therapeutic apheresis, the guidelines of the Apheresis Application Committee of the American Society for Apheresis are cited. Therapeutic apheresis has been shown to effectively remove the toxins, autoantibodies, and other substances from blood and lead to rapid clinical improvement. Therapeutic plasma exchange or immunoadsorption aimed at the causative antibodies can be used in diseases caused by antibodies or immune complexes. Adjuvant drug therapies are different for different diseases and are typically individualized in type, dose and duration of use. Therapeutic apheresis can safely be performed in all severe ill patients and is most combined with an immunosuppression therapy. Human monoclonal antibodies are more introduced in hematologic diseases in recent years.

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Effect of ruxolitinib on the oral mucosa of patients with steroid-refractory chronic Graft-versus-Host disease and oral involvement

Cited by 5 publications

References 36 publications

Ruxolitinib, a JAK1/2 Inhibitor as Treatment for Paraneoplastic Pemphigus: A Case Report

Ruxolitinib, a JAK1/2 Inhibitor as Treatment for Paraneoplastic Pemphigus: A Case Report

Perspectives on oral chronic graft-versus-host disease from immunobiology to morbid diagnoses

Therapeutic Apheresis, Immunosuppression and Human Monoclonal Anti-bodies in Hematologic diseases most with im-munologic origin

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