{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T12:42:42Z","timestamp":1792586562396,"version":"4.5.0"},"reference-count":46,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"2","license":[{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"<jats:p>\n                    Steroid-refractory graft-versus-host disease (SR-GVHD) remains a major cause of morbidity and mortality after allogeneic hematopoietic stem cell transplantation. Ruxolitinib is food and drug administration (FDA) approved for patients \u226512 years, but data remain limited in other pediatric cohorts. This single-center retrospective study evaluated 77 acute (51% grades III\u2013IV) and 45 chronic (82% severe) SR-GVHD patients under 18 years of age (range 0\u201317). The overall response rate (ORR) was 83% and 87% in patients with acute and chronic SR-GVHD, respectively. The organ-specific ORRs in chronic SR-GVHD for the skin, gastrointestinal (GI) tract, liver, oral mucosa, eyes, lungs, joints, and genitalia were 71%, 83%, 88%, 56%, 52%, 37%, 42%, and 40%, respectively. Three-year overall survival was 70% (acute) and 85% (chronic). By 3 years, 43% of chronic and 60% of acute patients discontinued all immunosuppression. Age &lt; 12 years did not affect outcomes (acute ORR: 78% vs. 76%,\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    \u2009=\u20090.96; chronic ORR: 89% vs. 79%,\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    \u2009=\u20090.14). Hematological toxicity was the main adverse event. The initial ruxolitinib dose correlated with hematologic toxicity and liver function test elevations in chronic GVHD. These results support the efficacy and safety of ruxolitinib across pediatric age groups, though further prospective studies are needed to optimize dosing and long-term monitoring.\n                  <\/jats:p>","DOI":"10.4103\/hemoncstem.hemoncstem-d-25-00044","type":"journal-article","created":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T12:00:09Z","timestamp":1792584009000},"page":"e0044","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Ruxolitinib for the treatment of pediatric acute and chronic steroid-refractory graft-versus-host disease: Efficacy, safety, and outcomes"],"prefix":"10.4103","volume":"19","author":[{"given":"Nikita V.","family":"Levkovsky","sequence":"first","affiliation":[{"name":"R.M. Gorbacheva Memorial Institute of Hematology, Oncology and Transplantation, Pavlov University, Saint Petersburg, Russian Federation"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna A.","family":"Zvyagintseva","sequence":"additional","affiliation":[{"name":"R.M. Gorbacheva Memorial Institute of Hematology, Oncology and Transplantation, Pavlov University, Saint Petersburg, Russian Federation"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna A.","family":"Osipova","sequence":"additional","affiliation":[{"name":"R.M. Gorbacheva Memorial Institute of Hematology, Oncology and Transplantation, Pavlov University, Saint Petersburg, Russian Federation"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olesya V.","family":"Paina","sequence":"additional","affiliation":[{"name":"R.M. Gorbacheva Memorial Institute of Hematology, Oncology and Transplantation, Pavlov University, Saint Petersburg, Russian Federation"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ilya V.","family":"Kazantsev","sequence":"additional","affiliation":[{"name":"R.M. Gorbacheva Memorial Institute of Hematology, Oncology and Transplantation, Pavlov University, Saint Petersburg, Russian Federation"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olga A.","family":"Slesarchuk","sequence":"additional","affiliation":[{"name":"R.M. Gorbacheva Memorial Institute of Hematology, Oncology and Transplantation, Pavlov University, Saint Petersburg, Russian Federation"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lubov A.","family":"Tsvetkova","sequence":"additional","affiliation":[{"name":"R.M. Gorbacheva Memorial Institute of Hematology, Oncology and Transplantation, Pavlov University, Saint Petersburg, Russian Federation"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhemal Z.","family":"Rakhmanova","sequence":"additional","affiliation":[{"name":"R.M. Gorbacheva Memorial Institute of Hematology, Oncology and Transplantation, Pavlov University, Saint Petersburg, Russian Federation"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Polina V.","family":"Kozhokar","sequence":"additional","affiliation":[{"name":"R.M. Gorbacheva Memorial Institute of Hematology, Oncology and Transplantation, Pavlov University, Saint Petersburg, Russian Federation"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oleg V.","family":"Goloshchapov","sequence":"additional","affiliation":[{"name":"R.M. Gorbacheva Memorial Institute of Hematology, Oncology and Transplantation, Pavlov University, Saint Petersburg, Russian Federation"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elena V.","family":"Lisukova","sequence":"additional","affiliation":[{"name":"R.M. Gorbacheva Memorial Institute of Hematology, Oncology and Transplantation, Pavlov University, Saint Petersburg, Russian Federation"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kulagin A.","family":"Egor","sequence":"additional","affiliation":[{"name":"R.M. Gorbacheva Memorial Institute of Hematology, Oncology and Transplantation, Pavlov University, Saint Petersburg, Russian Federation"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chistyakova V.","family":"Natalya","sequence":"additional","affiliation":[{"name":"R.M. Gorbacheva Memorial Institute of Hematology, Oncology and Transplantation, Pavlov University, Saint Petersburg, Russian Federation"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tultseva R.","family":"Valeria","sequence":"additional","affiliation":[{"name":"R.M. Gorbacheva Memorial Institute of Hematology, Oncology and Transplantation, Pavlov University, Saint Petersburg, Russian Federation"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gennadii G.","family":"Rodionov","sequence":"additional","affiliation":[{"name":"Nikiforov Russian Center of Emergency and Radiation Medicine, Saint Petersburg, Russian Federation"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ekaterina V.","family":"Svetkina","sequence":"additional","affiliation":[{"name":"Nikiforov Russian Center of Emergency and Radiation Medicine, Saint Petersburg, Russian Federation"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tatyana A.","family":"Bykova","sequence":"additional","affiliation":[{"name":"R.M. Gorbacheva Memorial Institute of Hematology, Oncology and Transplantation, Pavlov University, Saint Petersburg, Russian Federation"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elena V.","family":"Semenova","sequence":"additional","affiliation":[{"name":"R.M. Gorbacheva Memorial Institute of Hematology, Oncology and Transplantation, Pavlov University, Saint Petersburg, Russian Federation"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander D.","family":"Kulagin","sequence":"additional","affiliation":[{"name":"R.M. Gorbacheva Memorial Institute of Hematology, Oncology and Transplantation, Pavlov University, Saint Petersburg, Russian Federation"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ivan S.","family":"Moiseev","sequence":"additional","affiliation":[{"name":"R.M. Gorbacheva Memorial Institute of Hematology, Oncology and Transplantation, Pavlov University, Saint Petersburg, Russian Federation"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ludmila S.","family":"Zubarovskaya","sequence":"additional","affiliation":[{"name":"R.M. Gorbacheva Memorial Institute of Hematology, Oncology and Transplantation, Pavlov University, Saint Petersburg, Russian Federation"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2026,7]]},"reference":[{"key":"R1-20261021","doi-asserted-by":"crossref","first-page":"803","DOI":"10.1038\/s41409-024-02248-9","article-title":"Hematopoietic cell transplantation and cellular therapies in Europe 2022. 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Death after hematopoietic stem cell transplantation: changes over calendar year time, infections and associated factors","volume":"55","author":"Styczy\u0144ski","year":"2020","journal-title":"Bone Marrow Transplant"},{"key":"R9-20261021","doi-asserted-by":"crossref","first-page":"4651","DOI":"10.1182\/blood-2010-11-319509","article-title":"Patient-reported quality of life is associated with severity of chronic graft-versus-host disease as measured by NIH criteria: report on baseline data from the chronic GVHD consortium","volume":"117","author":"Pidala","year":"2011","journal-title":"Blood"},{"key":"R10-20261021","doi-asserted-by":"crossref","first-page":"2285","DOI":"10.1016\/j.bbmt.2018.07.020","article-title":"Impact of psychological distress on quality of life, functional status, and survival in patients with chronic graft-versus-host disease","volume":"24","author":"El-Jawahri","year":"2018","journal-title":"Biol Blood Marrow Transplant"},{"key":"R11-20261021","doi-asserted-by":"crossref","first-page":"e147","DOI":"10.1016\/S2352-3026(23)00342-3","article-title":"Prophylaxis and management of graft-versus-host disease after stem-cell transplantation for haematological malignancies: updated consensus recommendations of the European Society for Blood and Marrow Transplantation","volume":"11","author":"Penack","year":"2024","journal-title":"Lancet Haematol"},{"key":"R12-20261021","doi-asserted-by":"crossref","first-page":"601953","DOI":"10.1155\/2011\/601953","article-title":"Steroid-refractory acute GVHD: predictors and outcomes","volume":"2011","author":"Westin","year":"2011","journal-title":"Adv Hematol"},{"key":"R13-20261021","doi-asserted-by":"crossref","first-page":"2297","DOI":"10.1016\/j.bbmt.2019.07.017","article-title":"Outcomes and predictors of response in steroid-refractory acute graft-versus-host disease","volume":"25","author":"Rashidi","year":"2019","journal-title":"Biol Blood Marrow Transplant"},{"key":"R14-20261021","doi-asserted-by":"crossref","first-page":"e0170259","DOI":"10.1371\/journal.pone.0170259","article-title":"Systematic review of the toxicity of long-course oral corticosteroids in children","volume":"12","author":"Aljebab","year":"2017","journal-title":"PLoS One"},{"key":"R15-20261021","doi-asserted-by":"crossref","first-page":"1499","DOI":"10.1007\/s40265-019-01174-1","article-title":"Janus kinase inhibition for graft-versus-host disease: current Status and future prospects","volume":"79","author":"Mannina","year":"2019","journal-title":"Drugs"},{"key":"R16-20261021","doi-asserted-by":"crossref","first-page":"1192","DOI":"10.1182\/blood-2013-03-484642","article-title":"The JAK-inhibitor ruxolitinib impairs dendritic cell function in vitro and in vivo","volume":"122","author":"Heine","year":"2013","journal-title":"Blood"},{"key":"R17-20261021","doi-asserted-by":"crossref","first-page":"3832","DOI":"10.1182\/blood-2013-12-543736","article-title":"Activity of therapeutic JAK 1\/2 blockade in graft-versus-host disease","volume":"123","author":"Spoerl","year":"2014","journal-title":"Blood"},{"key":"R18-20261021","doi-asserted-by":"crossref","first-page":"1800","DOI":"10.1056\/NEJMoa1917635","article-title":"REACH2 Trial Group. 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Ruxolitinib in acute and chronic graft-versus-host disease: real life long-term experience in a multi-center study for adult and pediatric patients, on behalf of the GETH-TC","volume":"60","author":"Escamilla-G\u00f3mez","year":"2025","journal-title":"Bone Marrow Transplant"},{"key":"R45-20261021","doi-asserted-by":"crossref","first-page":"1150","DOI":"10.1016\/j.bbmt.2012.04.005","article-title":"First- and second-line systemic treatment of acute graft \u2212versus-host disease: recommendations of the American Society of Blood and Marrow Transplantation","volume":"18","author":"Martin","year":"2012","journal-title":"Biol Blood Marrow Transplant"},{"key":"R46-20261021","doi-asserted-by":"crossref","first-page":"2888","DOI":"10.1182\/blood-2008-07-168401","article-title":"Initial therapy of acute graft-versus-host disease with low-dose prednisone does not compromise patient outcomes","volume":"113","author":"Mielcarek","year":"2009","journal-title":"Blood"}],"container-title":["Hematology\/Oncology and Stem Cell Therapy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/hemoncstem.hemoncstem-D-25-00044","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T12:00:15Z","timestamp":1792584015000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/hemoncstem.hemoncstem-D-25-00044"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7]]},"references-count":46,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2026]]}},"URL":"https:\/\/doi.org\/10.4103\/hemoncstem.hemoncstem-d-25-00044","relation":{},"ISSN":["1658-3876","2589-0646"],"issn-type":[{"value":"1658-3876","type":"print"},{"value":"2589-0646","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7]]},"assertion":[{"value":"2025-10-23","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-08-10","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}