Imatinib and Rituximab in Treating Cutaneous Sclerosis in Patients With Chronic Graft-Versus-Host Disease

Inclusion Criteria:

   - Diagnosis within the past 18 months of cutaneous sclerosis after hematopoietic cell
   transplant (HCT) with sclerotic skin, morphea, myofascial involvement or joint
   contractures; must have a score of 2 or greater on the Vienna skin scale in any area,
   or a range-of-motion (ROM) score of 5 or less at the shoulder, elbow or wrist, or 3 or
   less at the ankle

   - No medication added for the treatment of graft versus host disease (GVHD) within the
   past 4 weeks

   - Receiving corticosteroids at a dose greater than required for treatment of adrenal
   insufficiency, unless the physician documents why steroids are contraindicated

   - Age 2-99 years

   - Karnofsky performance status >= 60% at enrollment

   - All females of childbearing potential must have a negative serum or urine pregnancy
   test =< 7 days prior to starting study therapy

   - All females of childbearing potential must agree to use a form of Food and Drug
   Administration (FDA) approved contraception from enrollment to one month after study
   treatment ends

   - Subject has the ability to understand and willingness to sign a written informed
   consent document

Exclusion Criteria:

   - Total bilirubin > 1.5x upper limit of normal (ULN)

   - Aspartate aminotransferase (AST) or alanine aminotransferase (ALT) > 2.5 x ULN

   - Renal insufficiency (serum creatinine > 2.0 mg/dl)

   - Platelets < 30,000/ul or absolute neutrophil count < 1500/ul

   - Known hypersensitivity to rituximab or other anti-B cell antibodies

   - Known imatinib intolerance or allergy

   - Evidence of any active viral, bacterial, or fungal infection that is progressive
   despite appropriate treatment

   - Hepatitis B surface antigen positive

   - Hepatitis B core antibody positive, unless hepatitis B virus (HBV) deoxyribonucleic
   acid (DNA) is undetectable

   - Hepatitis C antibody positive, unless hepatitis C virus (HCV) ribonucleic acid (RNA)
   is undetectable

   - Pregnant, lactating, or planning a pregnancy while in the study

   - Distal leg skin score 3 or higher as the only manifestation of sclerosis

   - Prior treatment of chronic GVHD with imatinib, rituximab, or any other monoclonal
   B-cell antibody (e.g. ofatumumab)

   - Receipt of imatinib within the previous 6 months for any indication

   - Receipt of any monoclonal B-cell antibody (e.g. rituximab, ofatumumab) within the
   previous 12 months for any indication

   - Treatment with anti-B-cell cellular therapy (e.g. chimeric antigen-receptor-engineered
   cells) at any time after transplant

   - Current treatment with extracorporeal photopheresis (ECP) at the time of enrollment

   - History of psychiatric disorder that would interfere with normal participation in this
   study

   - Inability or unwillingness of subject and/or parent guardian to provide informed
   consent or comply with study protocol

   - Use of non-FDA approved drugs within 4 weeks of participation

   - Patient with any condition that, in the opinion of the investigator, would interfere
   with the subject's ability to comply with the study requirements

   - Patients with uncontrolled substance abuse