First-Line Jaktinib for Acute Graft-Versus-Host Disease (aGVHD)

Exclusion Criteria24

• History of ≥2 allo-HSCT procedures.
• Development of aGVHD following unplanned donor lymphocyte infusion (DLI) for relapse of underlying malignancy. Note: Planned DLI as part of the transplant protocol is permitted.
• Concurrent treatment with another JAK inhibitor. Note: Patients who previously discontinued JAK inhibitors due to toxicity (not refractory aGVHD) are eligible.
• Active bleeding.
• Diagnosed or suspected chronic GVHD.
• Uncontrolled active infection, defined as sepsis-induced hemodynamic instability or progressive symptoms/signs/imaging findings attributable to infection. Asymptomatic or persistent fever alone is not exclusionary.
• unresolved toxicity or complications from allo-HSCT (excluding aGVHD).
• Clinically significant abnormalities that may compromise safety, including: a) Uncontrolled diabetes (fasting glucose >13.9 mmol/L); b) Hypertension unresponsive to ≥2 agents (systolic BP ≥160 mmHg or diastolic BP ≥100 mmHg); c) Peripheral neuropathy ≥Grade 2 (per NCI CTCAE v5.0).
• Within 6 months prior to screening: NYHA Class III/IV heart failure, unstable angina, myocardial infarction, cerebrovascular accident, or pulmonary embolism.
• Arrhythmia requiring treatment or QTcB interval >480 ms at screening.
• Severe renal impairment (serum creatinine >1.5 × ULN) at screening.
• Pre-transplant history of gastrointestinal ulcers, gastrectomy, or intestinal resection that may impair drug absorption.
• Major surgery within 4 weeks prior to screening without full recovery.
• Cholestatic disorders or hepatic sinusoidal obstruction syndrome (SOS/VOD) at screening (defined as persistent hyperbilirubinemia and organ dysfunction unrelated to GVHD).
• Active uncontrolled viral infections at screening: HBV: HBsAg⁺ with detectable HBV-DNA, or detectable HBV-DNA regardless of HBsAg status; HCV: Anti-HCV antibody⁺ with detectable HCV-RNA.
• History of active tuberculosis within 6 months prior to screening.
• Epilepsy or current use of psychotropic/sedative medications.
• Pregnancy, lactation, or intention to conceive; male patients unwilling to use condoms during treatment and for 2 days after the last dose.
• Other active malignancies (excluding the transplanted hematologic malignancy) within 5 years.
• Current use of anticoagulants or antiplatelet agents (except low molecular weight heparin).
• Any condition that, in the investigator's judgment, may compromise patient safety or protocol compliance.
• Known hypersensitivity to jaktinib, its analogs, or excipients.
• Participation in another interventional clinical trial within 4 weeks prior to screening.
• Investigator determination of unsuitability for the study.