Efficacy of Ruxolitinib with corticosteroids in idiopathic pneumonia syndrome post-allogeneic hematopoietic stem cell transplantation: A single-center experience and systematic review
Abstract
Background: Idiopathic Pneumonia Syndrome (IPS) after allogeneic hematopoietic stem cell transplantation (allo-HSCT) is a life-threatening complication with high morbidity and mortality. This study evaluates the effectiveness of Ruxolitinib, a JAK1/2 inhibitor that modulates the immune response, in combination with corticosteroids (CS), which have anti-inflammatory and immunosuppressive effects, in managing IPS after allo-HSCT.
Methods: The study includes a retrospective case series of three patients treated for IPS with Ruxolitinib and CS from the University of Kansas Medical Center and a systematic review of seven studies involving 346 cases, including our case series. Statistical analyses were conducted using SPSS.
Results: The case series included three patients with IPS after allo-HSCT who received ruxolitinib and CS. Patient A was a 72-year-old man with a history of acute myeloid leukemia (AML) in first complete remission (CR1), underwent allo-HSCT with a haploidentical donor with Fludarabine, Cyclophosphamide, and Total Body Irradiation (Flu/Cy/TBI) reduced intensity conditioning (RIC) and Post-Transplant Cyclophosphamide (PTCy), Tacrolimus (Tac) and Mycophenolate Mofetil (MMF) for GVHD prophylaxis, who developed five months after the transplant. Patient B was a 30-year-old man with a history of chemotherapy-refractory B-cell acute lymphoblastic leukemia (ALL) with CR1 after Brexucabtagene autoleucel chimeric antigen receptor (CAR) T-cell therapy who underwent…
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