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Leflunomide for chronic musculoskeletal graft versus host disease following allogeneic hematopoietic stem cell transplant

Bone Marrow Transplantation volume 55, pages 467–469 (2020)Cite this article

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Chronic graft versus host disease (cGVHD) is a major cause of morbidity and mortality post allogeneic stem cell transplant (HSCT). Musculoskeletal cGVHD (mGVHD) is characterized by a myriad of manifestations—fasciitis, myositis, arthritis, sclerotic contracture etc. The pathogenesis is similar to rheumatoid arthritis (RA), and involves several different immune cells and cytokines, with T cell playing a key role [1]. The treatment goals of mGVHD include improvement or stabilization of manifestations and minimizing long-term drug toxicities, thereby improving quality of life. Many drugs have been used with variable response rates, toxicities, and costs [2].

Leflunomide has action against T cell proliferation and is useful in RA [3]. It has been used in many settings in solid organ transplant (both animal and humans) and HSCT (animal models) [4,5,6,7,8,9]. Its use in human HSCT for GVHD is not known. Here we describe our experience with leflunomide in mGVHD.

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Authors and Affiliations

  1. HSCT unit, Department of Medical Oncology, Tata Memorial Centre, ACTREC, Kharghar, Navi Mumbai, 410210, India

    Sachin Punatar, Aniket Mohite, Anant Gokarn, Lingaraj Nayak, Avinash Bonda, Kartthik Shanmugam, Kalasekhar Vijaysekharan & Navin Khattry

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  1. Sachin Punatar
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  2. Aniket Mohite
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Correspondence to Navin Khattry.

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Punatar, S., Mohite, A., Gokarn, A. et al. Leflunomide for chronic musculoskeletal graft versus host disease following allogeneic hematopoietic stem cell transplant. Bone Marrow Transplant 55, 467–469 (2020). https://doi.org/10.1038/s41409-019-0545-x

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