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BMT: Anyone had Jakafi for GVHD Treatment?

Posted by edb1123 @edb1123, Aug 26, 2022

I had a bone marrow transplant 2 years ago, but I’ve had high liver enzymes this summer and last summer due to GVHD. I was treated with high doses of Prednisone and eventually they went back to normal. However, I’m now being put on Jakafi to treat the GVHD, along with Cressemba antifungal (instead of Micafungin). Has anyone taken Jakafi and/or Cressemba? I’m wondering if this is a common treatment, if it was effective, and if you had any side effects.

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Lori, Volunteer Mentor | @loribmt | 9 hours ago
In reply to @scottmatteo "I’m (51 yo male) nearly 15 months post SCT for pMF doing well except liver enzymes..." + (show)
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I’m (51 yo male) nearly 15 months post SCT for pMF doing well except liver enzymes are elevated. Prior to SCT I had one enzyme that was high but decided to proceed. Post SCT the enzymes took turns at normal and above normal to the point that they were normally above normal together. Dr ordered a more on depth blood test and my GGT was high- though I haven’t had a drink since prior to SCT bile ducts nor liver had any issues per MRI. This GVHD of liver pred helped but now tapered off and on Jakifi with mixed results. Went as high as 15mg twice a day to now -10 and 15 each once a day. Enzymes slowly rising again… platelets are normal RBC and Hgb are low but sustainable.
Beginning to wonder if I’m reacting to all the other meds anti bacterial anti fungal etc.
Better than the alternative.
Be well.

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Hi @scottmatteo Our livers can take ‘quite a licking but keep on ticking’…remember the old Timex commercials? 😅
My liver was impacted by the high intensity chemo for my AML treatments for several months before the transplant. So, of course it was also on high alert post BMT. If it’s any consolation, last September was the first time in 6 years that my liver enzymes were all in the ‘happy’ zone. (I’m now 7+ years post BMT)

It doesn’t take much to upset the those lab numbers. For me, even an OCT multi-vitamin elevated my numbers because of the excess Vitamin A. So if you’re still on the antibacterial/antifungals/antivirals along with some anti-rejection/anti-inflammatory meds those can certainly have an impact. GVHD was nibbling around the edges of my liver for quite some time. Being able to get off the meds helped. I was on Tacro (and the full war chest) for 2.5 years. It took time after weaning off everything for the liver to fully moderate.

Watching what we eat can be helpful as well. There are some foods that really benefit the liver. Here is just a brief list from Medical News Today
https://www.medicalnewstoday.com/articles/323915
Also, I remember having to return to Ursodiol for a while, which can help keep the liver cleared. Was ursodiol on your med list?

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