Sclerotic chronic graft-versus-host disease (scGVHD) is a severe form of this 
disease that resembles systemic sclerosis and has limited and disappointing 
treatment options. Tyrosine kinase inhibitors (TKI) targeting up-regulated 
profibrotic pathways, such as imatinib mesylate, have been proposed as a 
potential therapeutic approach for patients with scGVHD. Dasatinib, a 
second-generation TKI with a well-established safety and efficacy profile in 
chronic myeloid leukemia patients, who are refractory or intolerant to imatinib, 
has also shown potent antifibrotic effects. We present here the first direct 
clinical evidence, from 3 patients treated in a small single-center series, 
suggesting that dasatinib can be a therapeutic option for patients with severe 
scGVHD resistant or intolerant to imatinib. All patients achieved partial 
response, with improvement in scGHVD target organs severity, joint mobility, 
lung impairment, and deep fibrotic lesions. This clinical response has remained 
stable or continued to improve after a median of 22 months (20-25) on dasatinib 
treatment, with very good tolerance. In addition, corticosteroids could be 
discontinued or significantly reduced in all patients. This clinical evidence 
suggests that dasatinib could be a safe and effective alternative for scGVHD 
patients refractory to corticosteroids and resistant or intolerant to imatinib. 
Based on these preliminary findings, and in order to address appropriate patient 
selection, time of intervention, and choice of drug, future larger studies 
should more formally establish the efficacy and safety of second-generation TKI 
for the treatment of scGVHD.