A Pilot Study of Imatinib Mesylate in Steroid Refractory Chronic Graft Versus Host Disease

INCLUSION CRITERIA * Chronic graft-vs-host disease (cGVHD) requiring systemic therapy occurring \> 100 days after hematopoietic cell transplant with either: 1. Persistent steroid dependence defined as the inability to taper steroid treatment to less than 0.25 mg/kg/d prednisone or its equivalent for at least 3 months. 2. Progression of cGVHD signs and symptoms on steroid therapy equivalent to prednisone 0.5 mg/kg/d for at least 1 month. * At least one of the following manifestations: 1. Skin changes (rash, sclerosis, fasciitis, or ulceration). 2. Abnormal eye wetness ≤ 5 mm as measured by Schirmer's test. 3. Oral mucosal changes (erythema, lichenoid changes, ulcers, or mucoceles). 4. Thrombocytopenia (platelets \< 50,000/uL). 5. Abnormal liver function testing defined as alkaline phosphatase, AST, ALT, or total bilirubin \> upper limit of normal (ULN). 6. Bronchiolitis obliterans (diagnosed by a \> 5% annual decline in FEV1 with the lowest post-transplant FEV1/FVC \< 0.8 and an appropriate CT scan or lung biopsy). * Has been on a fixed dose of steroids or a fixed dose of steroids and one other immunosuppressant (cyclosporine, tacrolimus, sirolimus, mycophenolate mofetil, or extracorporeal photopheresis) for ≥ 30 days before starting imatinib. * Life expectancy ≥ 6 months. * Ability to understand and willingness to sign a written informed consent document. * Karnofsky performance status ≥ 3 50% (Appendix B). * At least 18 years of age. * If a female of reproductive potential (defined as having at least 1 menstrual period in the past 12 months), must have a negative pregnancy test performed ≤ 7 days before starting study drug. * If a female of reproductive potential, agrees to use contraception for the duration of the trial. * Total bilirubin \< 1.5X ULN. * Aspartate transaminase (AST) \< 2.5 x ULN. * Alanine aminotransferase (ALT) \< 2.5 x ULN. * Alkaline phosphatase \< 2.5 x ULN. * Absolute neutrophil count (ANC) \> 500/uL (growth factor supplementation is allowed). * Hematocrit \> 26% (transfusion support is allowed). * Platelet count \> 20,000/uL. EXCLUSION CRITERIA * Received another investigational agent ≤ 30 days before starting the study drug. * Ongoing intercurrent illness such as an infection not responsive to antibiotics, antiviral medicines, or antifungal medicines. * Progressive malignant disease. * Secondary malignancy that has not been effectively treated within the past 5 years (except localized basal cell or squamous cell carcinoma). * Imatinib intolerance or allergy. * Participant is breast-feeding. * Not willing to comply with treatment or response evaluation. * Received an allogeneic cell product \[including donor lymphocyte infusion (DLI) or hematopoietic cell boost\] ≤ 100 days before starting study drug. * Steroid and/or immunosuppressant dose has changed ≤ 30 days before starting study drug.