Case 5:
A 14-year-old female with MDS underwent a haploidentical HSCT
complicated by SD aGVHD of the liver. This was preceded by grade 1
steroid-responsive aGVHD of the gut, B-K viremia and viruria, HHV-6
viremia, CMV viremia and hypertension. Throughout her HSCT course, she
had aGVHD flares of skin and gut due to non-compliance with her
immunosuppression. Each flare was steroid responsive. Shortly after day
+300, she developed worsening transaminitis and skin GVHD that was SD.
Bortezomib was started with successful steroid wean initiated within one
week of her initial bortezomib dose (Table 1). Over the subsequent three
months, while receiving weekly bortezomib, she was successfully weaned
from steroids.