Successful dupilumab treatment in a patient with severe dermatitis following allogenic hematopoietic stem cell transplantation

Abstract

Background: Allogenic hematopoietic stem cell transplantation (HSCT) is the optimal treatment of hematologic diseases and various malignancies. Development of allergic disease in a transplant patient has been reported. Case presentations: A 49-year-old male with no history of atopy underwent two allogenic HSCTs for aplastic anemia from his brother with severe atopic dermatitis 11 years ago. The patient developed eczema on whole body and an elevated peripheral blood eosinophil count of 5775 cells/µL at 3 months after the second HSCT. Despite prolonged treatment with systemic corticosteroids and immunomodulators the skin rash and elevated blood eosinophil count persisted. However, after 4 months of dupilumab therapy, the patient showed near-complete clearance of symptoms. The sustained clinical improvement was observed during 36 months treatment without adverse drug reactions. Conclusions: Although rare, atopic dermatitis can occur after HSCT, and dupilumab may be safe and effective for refractory conditions.