It's fully compatible with nodejs, so super feasible to do backend dev
I've also been slowly working on a small CLI app using ReasonML, ReasonReact and react-blessed.
There definitely is a dearth of ReasonML server-side examples, libraries and frameworks, though - especially compared to all the front-end chatter. bs-express[1] is actually quite nice, but hasn't seen much attention from the larger community. I would highly recommend it if it's something you're interested in pursuing.