Ruxolitinib reduces GVHD in patients with acute corticosteroid-refractory GVHD. All patients were refractory to steroids and at least 2 other lines of treatment of GVHD (see also Table 1). (A) Two patients with histologically proven intestinal GVHD grade IV were treated with ruxolitinib as described in Methods. The frequency of diarrhea decreased in both patients. No other immunosuppressive therapy was started at the same time point. The patients also had corticosteroids and everolimus when ruxolitinib was started, and corticosteroids could be tapered in both patients during ruxolitinib treatment. (B) One patient with clinically diagnosed liver GVHD grade III was treated with ruxolitinib 5 mg twice per day for the first 3 days and then 10 mg twice per day continuously. The bilirubin level decreased after ruxolitinib treatment. No other immunosuppressive therapy was started at the same time point but corticosteroid treatment (blue area) was reduced by 50% and then discontinued in the observation period. The patient received no additional liver toxic agent that was discontinued during the entire time that is displayed. (C-D) The IL-6 and soluble IL-2R were measured before and after the start of ruxolitinib (range, 1-2 days before at latest 8 days after treatment start). The levels of these serum parameters declined in all analyzed patients. (E) A representative patient with cutaneous GVHD is shown before and 1.5 weeks after ruxolitinib. The patient characteristics and responses are summarized in Table 1 and supplemental Table 1.