Case 1:
A 7-year-old male patient with high-risk AML developed initial
gastrointestinal and ocular GVHD 23 days post-allogenic HSCT. He was
initially on prednisone and sirolimus; first attempts included weaning
him from prednisone with extracorporeal photopheresis (ECP), but he
continued to have multiple skin GVHD flares with worsening
manifestations to grade 4 aGVHD. Bortezomib was initiated due to
continued steroid dependence (Table 1). Due to development of
pancytopenia, dose reduction was required temporally, before increasing
again. His skin lesions steadily improved, permitting bortezomib dose
taper to discontinuation and discontinuation of prednisone with
subsequently stopped all immune suppression.