A Case of Refractory Polyarticular Juvenile Idiopathic Arthritis Post-hematopoietic Stem Cell Transplantation Successfully Treated With Ruxolitinib

TL;DR

A child with severe arthritis after a stem cell transplant was successfully treated with ruxolitinib when other treatments failed.

Contribution

This case demonstrates ruxolitinib's effectiveness in treating refractory juvenile arthritis after stem cell transplants.

Findings

Ruxolitinib induced clinical remission in a patient with post-transplant arthritis.

The patient remained in remission for over two years without adverse events or cancer recurrence.

Abstract

Allogeneic hematopoietic stem cell transplantation (allo-HSCT) may trigger secondary autoimmune diseases, with autoimmune arthritis representing a rare yet challenging complication.

Here, we report a six-year-old male who developed polyarticular juvenile idiopathic arthritis (JIA) three years after allo-HSCT for lymphoma. Despite resistance to multiple biologic disease-modifying anti-rheumatic drugs (bDMARDs), including adalimumab and tocilizumab, treatment with the Janus kinase 1/2 inhibitor ruxolitinib achieved clinical remission sustained for over two years without significant adverse events or lymphoma relapse.

Ruxolitinib may represent a viable therapeutic option for refractory secondary JIA post-allo-HSCT, particularly when conventional bDMARDs fail.

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