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The following is a summary of “Chronic graft-versus-host disease myelitis successfully treated with rituximab,” published in the January 2025 issue of Hematology by Yokoyama et al.
Chronic graft-versus-host disease (cGVHD) is a serious complication after allogeneic stem-cell transplantation (allo-HSCT) that often mimics autoimmune diseases. Central nervous system (CNS) symptoms are rare and challenging to diagnose, classified as atypical manifestations in the 2020 NIH cGVHD Consensus Project.
Researchers conducted a retrospective study on a case of myelitis after allo-HSCT diagnosed as cGVHD of the CNS.
They administered corticosteroid pulse therapy, but neurological symptoms progressed, resulting in severe paralysis and paresthesia of the lower extremities. Clinical course and MRI findings showed similarities with multiple sclerosis. Rituximab was used after the patient became refractory to corticosteroids, as rituximab is effective in multiple sclerosis by suppressing B cells on both sides of the blood–brain barrier.
The results showed rituximab was effective for the neurologic symptoms in the case.
Investigators concluded that treatments used in corresponding autoimmune diseases were reasonable and effective in atypical cGVHD.
Source: link.springer.com/article/10.1007/s12185-025-03936-y
