A 21-year-old Hispanic man with a medical history of myelodysplastic syndrome underwent related HLA-identical allogeneic stem cell transplantation at the age of 11 years. His conditioning regimen included cyclophosphamide, cytarabine, and total-body irradiation. The posttransplantation course was complicated by chronic graft-versus-host disease (cGVHD) involving the liver, skin, and oral mucosa, for which he was prescribed tacrolimus for the last 8 years with a slow taper.