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Final Program


Final Program

877 - Successful creatine supplementation in a patient with cGvHD

Friday, February 28, 2025
5:00 PM - 6:30 PM MST

    Presenting Author(s)

  • CK

    Caitlyn Ko, MD

    Resident Physician
    New York Presbyterian Columbia/Cornell
    New York, New York, United States

    • Co-Author(s)

  • GS

    Grigory Syrkin, MD

    Attending Physician
    Memorial Sloan Kettering Cancer Center
    New York, New York, United States

  • SW

    Sammy Wu, MD

    Fellow Physician
    Memorial Sloan Kettering Cancer Center
    New York, New York, United States

  • AM

    Alina Markova, MD

    Vice Chair, Quality, Department of Medicine, Section Head of General Dermatology and Oncodermatology
    Memorial Sloan Kettering Cancer Center
    NYC, New York, United States

  • DP

    Doris Ponce, MD

    Director, GVHD Program; Co-Chair, Center for Hematologic Malignancies Translational Research Council
    Memorial Sloan Kettering Cancer Center
    NYC, New York, United States

Case Diagnosis: We report a case of a 38-year-old female steroid myopathy and chronic graft-versus-host-disease (cGvHD) affecting connective tissue, who physically plateaued after two years of physical therapy but improved with creatine supplementation to her multidisciplinary care. 

Case Description: Patient had strength and joint mobility deficits following allogenic hematopoietic stem cell transplant for chronic myeloid leukemia, complicated by cGVHD and steroid myopathy. She developed exertional dyspnea, fatigue, cGVHD-induced neuropathy, pruritis, and bilateral contractures of arms and ankles. Her exam was notable for indurated, xerotic skin, decreased muscle bulk, restricted limb movement, weakness in both arms and legs.

Discussions:

The patient displayed persistent impairments despite completing formal therapies and compliance with self-directed exercises. Upon discussion with the patient and multidisciplinary oncology team, creatine monohydrate (CMH) supplementation was initiated at 5 gm/day. After two months, she was able to increase grip strength from right/left 16.7/16.2kg to 20/20kg (normal ranges 33.6/30.1kg), improve leg power from 190 to 212 watts, and increase forced vital capacity by 11%. She reported improved energy levels and had no subjective or objective adverse effects from CMH. 



 



Creatine’s ability to boost muscle function via accelerated glycogen storage is well-described in peer-reviewed literature. Low levels of creatine are associated with fatigue, hypoalbuminemia, and sarcopenia. CMH has been shown to be safe and effective in a variety of catabolic states, such as hemodialysis, aging, osteoporosis, congestive heart failure and mitochondrial disease. To our knowledge, there are no published reports of CMH use in cGvHD. 


Conclusions: While the improvement in grip strength was not clinically significant, CMH may have helped our cGvHD patient with a well-established activity routine break through her physical plateau. CMH supplementation may be a useful adjunct option for restorative care in cGvHD patients.