Baricitinib as Salvage Therapy for Multidrug‐Resistant Chronic Graft‐Versus‐Host Disease

Chronic graft-versus-host disease (cGVHD) remains the leading cause of late non-relapse morbidity and mortality after allogeneic hematopoietic stem-cell transplantation (allo-HSCT).Ruxolitinib, a Janus kinase (JAK) 1/2 inhibitor, is a standard treatment for glucocorticoid-refractory cGVHD, but grade ≥ 3 thrombocytopenia occurs in approximately 15% of treated patients and frequently forces dose reduction or discontinuation [ 1 ].Patients who become ruxolitinib-intolerant while their cGVHD remains active have few evidence-based options and a poor prognosis, and salvage agents such as belumosudil are not universally available [ 2 ].Such patients are typically heavily pre-treated and at high risk, and options that control cGVHD without further aggravating cytopenias remain scarce.We therefore reviewed our single-center experience with baricitinib in this difficult setting.