Autologous hematopoietic stem cell transplantation for autoimmune diseases
Identifieur interne : 00B383 ( Main/Merge ); précédent : 00B382; suivant : 00B384Autologous hematopoietic stem cell transplantation for autoimmune diseases
Auteurs : A. Gratwohl [Suisse] ; J. Passweg [Suisse] ; C. Bocelli-Tyndall [Suisse] ; A. Fassas [Grèce] ; J. M. Van Laar [Pays-Bas] ; D. Farge [France] ; M. Andolina [Italie] ; R. Arnold [Allemagne] ; E. Carreras [Espagne] ; J. Finke [Allemagne] ; I. Kötter [Allemagne] ; T. Kozak [République tchèque] ; I. Lisukov [Russie] ; B. Löwenberg [Pays-Bas] ; A. Marmont [Italie] ; J. Moore [Australie] ; R. Saccardi [Italie] ; J. A. Snowden [Royaume-Uni] ; F. Van Den Hoogen [Pays-Bas] ; N. M. Wulffraat [Pays-Bas] ; X. W. Zhao [République populaire de Chine] ; A. Tyndall [Suisse]Source :
- Bone marrow transplantation : (Basingstoke) [ 0268-3369 ] ; 2005.
Descripteurs français
- Pascal (Inist)
- Wicri :
- topic : Cellule souche.
English descriptors
- KwdEn :
Abstract
Experimental data and early phase I/II studies suggest that high-dose chemotherapy followed by autologous hematopoietic stem cell transplantation (HSCT) can arrest progression of severe autoimmune diseases. We have evaluated the toxicity and disease response in 473 patients with severe autoimmune disease treated with autologous HSCT between 1995 and 2003, from 110 centers participating in the European Group for Blood and Marrow Transplantation (EBMT) autoimmune disease working party database. Survival, transplant-related mortality, treatment response and disease progression were assessed. In all, 420 patients (89%; 86±4% at 3 years, median follow-up 20 months) were alive, 53 (11%) had died from transplant-related mortality (N=31; 7±3% at 3 years) or disease progression (N= 22; 9±4% at 3 years). Of 370 patients, 299 evaluable for response (81%) showed a treatment response, which was sustained in 213 (71% of responders). Response was associated with disease (P<0.001), was better in patients who received cyclophosphamide during mobilization (relative risk (RR)3.28 (1.57-6.83)) and was worse with increasing age (>40 years, RR0.29 (0.11-0.82)). Disease progression was associated with disease (P<0.001) and conditioning intensity (high intensity, RR1; intermediate intensity, RR1.81 (0.96-3.42)); low intensity, RR2.34 (1.074-5.11)). These data from the collective EBMT experience support the hypothesis that autologous HSCT can alter disease progression in severe autoimmune disease.
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Passweg</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>University Hospital</s1><s2>Basel</s2><s3>CHE</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ></inist:fA14><country>Suisse</country><wicri:noRegion>University Hospital</wicri:noRegion></affiliation></author><author><name sortKey="Bocelli Tyndall, C" sort="Bocelli Tyndall, C" uniqKey="Bocelli Tyndall C" first="C." last="Bocelli-Tyndall">C. Bocelli-Tyndall</name><affiliation wicri:level="1"><inist:fA14 i1="02"><s1>Stem Cell Transplant Team, Department of Rheumatology, University Basel, Felix Platter Spital</s1><s2>Basel</s2><s3>CHE</s3><sZ>3 aut.</sZ><sZ>22 aut.</sZ></inist:fA14><country>Suisse</country><wicri:noRegion>Basel</wicri:noRegion></affiliation></author><author><name sortKey="Fassas, A" sort="Fassas, A" uniqKey="Fassas A" first="A." last="Fassas">A. 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Farge</name><affiliation wicri:level="3"><inist:fA14 i1="05"><s1>Hôpital St Louis</s1><s2>Paris</s2><s3>FRA</s3><sZ>6 aut.</sZ></inist:fA14><country>France</country><placeName><region type="region">Île-de-France</region><region type="old region">Île-de-France</region><settlement type="city">Paris</settlement></placeName></affiliation></author><author><name sortKey="Andolina, M" sort="Andolina, M" uniqKey="Andolina M" first="M." last="Andolina">M. Andolina</name><affiliation wicri:level="1"><inist:fA14 i1="06"><s1>Istituto per l'Infanzia Burlo Garofolo</s1><s2>Trieste</s2><s3>ITA</s3><sZ>7 aut.</sZ></inist:fA14><country>Italie</country><wicri:noRegion>Istituto per l'Infanzia Burlo Garofolo</wicri:noRegion></affiliation></author><author><name sortKey="Arnold, R" sort="Arnold, R" uniqKey="Arnold R" first="R." last="Arnold">R. Arnold</name><affiliation wicri:level="3"><inist:fA14 i1="07"><s1>Universitätsklinikum Charité</s1><s2>Berlin</s2><s3>DEU</s3><sZ>8 aut.</sZ></inist:fA14><country>Allemagne</country><placeName><region type="land" nuts="3">Berlin</region><settlement type="city">Berlin</settlement></placeName></affiliation></author><author><name sortKey="Carreras, E" sort="Carreras, E" uniqKey="Carreras E" first="E." last="Carreras">E. Carreras</name><affiliation wicri:level="3"><inist:fA14 i1="08"><s1>Hospital Clinic</s1><s2>Barcelona</s2><s3>ESP</s3><sZ>9 aut.</sZ></inist:fA14><country>Espagne</country><placeName><settlement type="city">Barcelone</settlement><region nuts="2" type="region">Catalogne</region></placeName></affiliation></author><author><name sortKey="Finke, J" sort="Finke, J" uniqKey="Finke J" first="J." last="Finke">J. Finke</name><affiliation wicri:level="3"><inist:fA14 i1="09"><s1>Klinikum der Albert-Ludwigs Universität Freiburg</s1><s2>Freiburg</s2><s3>DEU</s3><sZ>10 aut.</sZ></inist:fA14><country>Allemagne</country><placeName><region type="land" nuts="1">Bade-Wurtemberg</region><region type="district" nuts="2">District de Fribourg-en-Brisgau</region><settlement type="city">Fribourg-en-Brisgau</settlement></placeName></affiliation></author><author><name sortKey="Kotter, I" sort="Kotter, I" uniqKey="Kotter I" first="I." last="Kötter">I. Kötter</name><affiliation wicri:level="3"><inist:fA14 i1="10"><s1>Medizinische Universitdtsklinik</s1><s2>Tübingen</s2><s3>DEU</s3><sZ>11 aut.</sZ></inist:fA14><country>Allemagne</country><placeName><region type="land" nuts="1">Bade-Wurtemberg</region><region type="district" nuts="2">District de Tübingen</region><settlement type="city">Tübingen</settlement></placeName></affiliation></author><author><name sortKey="Kozak, T" sort="Kozak, T" uniqKey="Kozak T" first="T." last="Kozak">T. Kozak</name><affiliation wicri:level="3"><inist:fA14 i1="11"><s1>University Hospital Krulovske Vinohrady</s1><s2>Prague</s2><s3>CZE</s3><sZ>12 aut.</sZ></inist:fA14><country>République tchèque</country><placeName><settlement type="city">Prague</settlement><region type="région" nuts="2">Bohême centrale</region></placeName></affiliation></author><author><name sortKey="Lisukov, I" sort="Lisukov, I" uniqKey="Lisukov I" first="I." last="Lisukov">I. Lisukov</name><affiliation wicri:level="1"><inist:fA14 i1="12"><s1>Institute of Clinical Immunology</s1><s2>Novosibirsk</s2><s3>RUS</s3><sZ>13 aut.</sZ></inist:fA14><country>Russie</country><wicri:noRegion>Institute of Clinical Immunology</wicri:noRegion></affiliation></author><author><name sortKey="Lowenberg, B" sort="Lowenberg, B" uniqKey="Lowenberg B" first="B." last="Löwenberg">B. Löwenberg</name><affiliation wicri:level="3"><inist:fA14 i1="13"><s1>Erasmus University Medical Center</s1><s2>Rotterdam</s2><s3>NLD</s3><sZ>14 aut.</sZ></inist:fA14><country>Pays-Bas</country><placeName><settlement type="city">Rotterdam</settlement><region nuts="2" type="province">Hollande-Méridionale</region></placeName></affiliation></author><author><name sortKey="Marmont, A" sort="Marmont, A" uniqKey="Marmont A" first="A." last="Marmont">A. Marmont</name><affiliation wicri:level="1"><inist:fA14 i1="14"><s1>Ospedale San Martino</s1><s2>Genova</s2><s3>ITA</s3><sZ>15 aut.</sZ></inist:fA14><country>Italie</country><wicri:noRegion>Ospedale San Martino</wicri:noRegion></affiliation></author><author><name sortKey="Moore, J" sort="Moore, J" uniqKey="Moore J" first="J." last="Moore">J. Moore</name><affiliation wicri:level="3"><inist:fA14 i1="15"><s1>St Vincents Hospital</s1><s2>Sydney</s2><s3>AUS</s3><sZ>16 aut.</sZ></inist:fA14><country>Australie</country><placeName><settlement type="city">Sydney</settlement><region type="état">Nouvelle-Galles du Sud</region></placeName></affiliation></author><author><name sortKey="Saccardi, R" sort="Saccardi, R" uniqKey="Saccardi R" first="R." last="Saccardi">R. Saccardi</name><affiliation wicri:level="1"><inist:fA14 i1="16"><s1>Ospedale di Careggi</s1><s2>Florence</s2><s3>ITA</s3><sZ>17 aut.</sZ></inist:fA14><country>Italie</country><wicri:noRegion>Ospedale di Careggi</wicri:noRegion></affiliation></author><author><name sortKey="Snowden, J A" sort="Snowden, J A" uniqKey="Snowden J" first="J. A." last="Snowden">J. A. Snowden</name><affiliation wicri:level="1"><inist:fA14 i1="17"><s1>Sheffield Teaching Hospitals NHS Trust</s1><s2>Sheffield</s2><s3>GBR</s3><sZ>18 aut.</sZ></inist:fA14><country>Royaume-Uni</country><wicri:noRegion>Sheffield Teaching Hospitals NHS Trust</wicri:noRegion></affiliation></author><author><name sortKey="Van Den Hoogen, F" sort="Van Den Hoogen, F" uniqKey="Van Den Hoogen F" first="F." last="Van Den Hoogen">F. Van Den Hoogen</name><affiliation wicri:level="3"><inist:fA14 i1="18"><s1>University Medical Center St Radboud</s1><s2>Nijmegen</s2><s3>NLD</s3><sZ>19 aut.</sZ></inist:fA14><country>Pays-Bas</country><placeName><settlement type="city">Nimègue</settlement><region type="province" nuts="2">Gueldre</region></placeName></affiliation></author><author><name sortKey="Wulffraat, N M" sort="Wulffraat, N M" uniqKey="Wulffraat N" first="N. M." last="Wulffraat">N. M. Wulffraat</name><affiliation wicri:level="3"><inist:fA14 i1="19"><s1>University Hospital for Children</s1><s2>Utrecht</s2><s3>NLD</s3><sZ>20 aut.</sZ></inist:fA14><country>Pays-Bas</country><placeName><settlement type="city">Utrecht</settlement><region nuts="2" type="province">Utrecht (province)</region></placeName></affiliation></author><author><name sortKey="Zhao, X W" sort="Zhao, X W" uniqKey="Zhao X" first="X. W." last="Zhao">X. W. Zhao</name><affiliation wicri:level="1"><inist:fA14 i1="20"><s1>The Third People Hospital of Zhengzhou</s1><s2>Zhengzhou</s2><s3>CHN</s3><sZ>21 aut.</sZ></inist:fA14><country>République populaire de Chine</country><wicri:noRegion>The Third People Hospital of Zhengzhou</wicri:noRegion></affiliation></author><author><name sortKey="Tyndall, A" sort="Tyndall, A" uniqKey="Tyndall A" first="A." last="Tyndall">A. Tyndall</name><affiliation wicri:level="1"><inist:fA14 i1="02"><s1>Stem Cell Transplant Team, Department of Rheumatology, University Basel, Felix Platter Spital</s1><s2>Basel</s2><s3>CHE</s3><sZ>3 aut.</sZ><sZ>22 aut.</sZ></inist:fA14><country>Suisse</country><wicri:noRegion>Basel</wicri:noRegion></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">INIST</idno><idno type="inist">05-0217360</idno><date when="2005">2005</date><idno type="stanalyst">PASCAL 05-0217360 INIST</idno><idno type="RBID">Pascal:05-0217360</idno><idno type="wicri:Area/PascalFrancis/Corpus">004978</idno><idno type="wicri:Area/PascalFrancis/Curation">001725</idno><idno type="wicri:Area/PascalFrancis/Checkpoint">004733</idno><idno type="wicri:explorRef" wicri:stream="PascalFrancis" wicri:step="Checkpoint">004733</idno><idno type="wicri:doubleKey">0268-3369:2005:Gratwohl A:autologous:hematopoietic:stem</idno><idno type="wicri:Area/Main/Merge">00B383</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a">Autologous hematopoietic stem cell transplantation for autoimmune diseases</title><author><name sortKey="Gratwohl, A" sort="Gratwohl, A" uniqKey="Gratwohl A" first="A." last="Gratwohl">A. Gratwohl</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>University Hospital</s1><s2>Basel</s2><s3>CHE</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ></inist:fA14><country>Suisse</country><wicri:noRegion>University Hospital</wicri:noRegion></affiliation></author><author><name sortKey="Passweg, J" sort="Passweg, J" uniqKey="Passweg J" first="J." last="Passweg">J. Passweg</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>University Hospital</s1><s2>Basel</s2><s3>CHE</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ></inist:fA14><country>Suisse</country><wicri:noRegion>University Hospital</wicri:noRegion></affiliation></author><author><name sortKey="Bocelli Tyndall, C" sort="Bocelli Tyndall, C" uniqKey="Bocelli Tyndall C" first="C." last="Bocelli-Tyndall">C. Bocelli-Tyndall</name><affiliation wicri:level="1"><inist:fA14 i1="02"><s1>Stem Cell Transplant Team, Department of Rheumatology, University Basel, Felix Platter Spital</s1><s2>Basel</s2><s3>CHE</s3><sZ>3 aut.</sZ><sZ>22 aut.</sZ></inist:fA14><country>Suisse</country><wicri:noRegion>Basel</wicri:noRegion></affiliation></author><author><name sortKey="Fassas, A" sort="Fassas, A" uniqKey="Fassas A" first="A." last="Fassas">A. Fassas</name><affiliation wicri:level="1"><inist:fA14 i1="03"><s1>George Papanicolaou Hospital</s1><s2>Thessaloniki</s2><s3>GRC</s3><sZ>4 aut.</sZ></inist:fA14><country>Grèce</country><wicri:noRegion>George Papanicolaou Hospital</wicri:noRegion></affiliation></author><author><name sortKey="Van Laar, J M" sort="Van Laar, J M" uniqKey="Van Laar J" first="J. M." last="Van Laar">J. M. Van Laar</name><affiliation wicri:level="3"><inist:fA14 i1="04"><s1>Leiden University Medical Center</s1><s2>Leiden</s2><s3>NLD</s3><sZ>5 aut.</sZ></inist:fA14><country>Pays-Bas</country><placeName><settlement type="city">Leyde</settlement><region nuts="2" type="province">Hollande-Méridionale</region></placeName></affiliation></author><author><name sortKey="Farge, D" sort="Farge, D" uniqKey="Farge D" first="D." last="Farge">D. Farge</name><affiliation wicri:level="3"><inist:fA14 i1="05"><s1>Hôpital St Louis</s1><s2>Paris</s2><s3>FRA</s3><sZ>6 aut.</sZ></inist:fA14><country>France</country><placeName><region type="region">Île-de-France</region><region type="old region">Île-de-France</region><settlement type="city">Paris</settlement></placeName></affiliation></author><author><name sortKey="Andolina, M" sort="Andolina, M" uniqKey="Andolina M" first="M." last="Andolina">M. Andolina</name><affiliation wicri:level="1"><inist:fA14 i1="06"><s1>Istituto per l'Infanzia Burlo Garofolo</s1><s2>Trieste</s2><s3>ITA</s3><sZ>7 aut.</sZ></inist:fA14><country>Italie</country><wicri:noRegion>Istituto per l'Infanzia Burlo Garofolo</wicri:noRegion></affiliation></author><author><name sortKey="Arnold, R" sort="Arnold, R" uniqKey="Arnold R" first="R." last="Arnold">R. Arnold</name><affiliation wicri:level="3"><inist:fA14 i1="07"><s1>Universitätsklinikum Charité</s1><s2>Berlin</s2><s3>DEU</s3><sZ>8 aut.</sZ></inist:fA14><country>Allemagne</country><placeName><region type="land" nuts="3">Berlin</region><settlement type="city">Berlin</settlement></placeName></affiliation></author><author><name sortKey="Carreras, E" sort="Carreras, E" uniqKey="Carreras E" first="E." last="Carreras">E. Carreras</name><affiliation wicri:level="3"><inist:fA14 i1="08"><s1>Hospital Clinic</s1><s2>Barcelona</s2><s3>ESP</s3><sZ>9 aut.</sZ></inist:fA14><country>Espagne</country><placeName><settlement type="city">Barcelone</settlement><region nuts="2" type="region">Catalogne</region></placeName></affiliation></author><author><name sortKey="Finke, J" sort="Finke, J" uniqKey="Finke J" first="J." last="Finke">J. Finke</name><affiliation wicri:level="3"><inist:fA14 i1="09"><s1>Klinikum der Albert-Ludwigs Universität Freiburg</s1><s2>Freiburg</s2><s3>DEU</s3><sZ>10 aut.</sZ></inist:fA14><country>Allemagne</country><placeName><region type="land" nuts="1">Bade-Wurtemberg</region><region type="district" nuts="2">District de Fribourg-en-Brisgau</region><settlement type="city">Fribourg-en-Brisgau</settlement></placeName></affiliation></author><author><name sortKey="Kotter, I" sort="Kotter, I" uniqKey="Kotter I" first="I." last="Kötter">I. Kötter</name><affiliation wicri:level="3"><inist:fA14 i1="10"><s1>Medizinische Universitdtsklinik</s1><s2>Tübingen</s2><s3>DEU</s3><sZ>11 aut.</sZ></inist:fA14><country>Allemagne</country><placeName><region type="land" nuts="1">Bade-Wurtemberg</region><region type="district" nuts="2">District de Tübingen</region><settlement type="city">Tübingen</settlement></placeName></affiliation></author><author><name sortKey="Kozak, T" sort="Kozak, T" uniqKey="Kozak T" first="T." last="Kozak">T. Kozak</name><affiliation wicri:level="3"><inist:fA14 i1="11"><s1>University Hospital Krulovske Vinohrady</s1><s2>Prague</s2><s3>CZE</s3><sZ>12 aut.</sZ></inist:fA14><country>République tchèque</country><placeName><settlement type="city">Prague</settlement><region type="région" nuts="2">Bohême centrale</region></placeName></affiliation></author><author><name sortKey="Lisukov, I" sort="Lisukov, I" uniqKey="Lisukov I" first="I." last="Lisukov">I. Lisukov</name><affiliation wicri:level="1"><inist:fA14 i1="12"><s1>Institute of Clinical Immunology</s1><s2>Novosibirsk</s2><s3>RUS</s3><sZ>13 aut.</sZ></inist:fA14><country>Russie</country><wicri:noRegion>Institute of Clinical Immunology</wicri:noRegion></affiliation></author><author><name sortKey="Lowenberg, B" sort="Lowenberg, B" uniqKey="Lowenberg B" first="B." last="Löwenberg">B. Löwenberg</name><affiliation wicri:level="3"><inist:fA14 i1="13"><s1>Erasmus University Medical Center</s1><s2>Rotterdam</s2><s3>NLD</s3><sZ>14 aut.</sZ></inist:fA14><country>Pays-Bas</country><placeName><settlement type="city">Rotterdam</settlement><region nuts="2" type="province">Hollande-Méridionale</region></placeName></affiliation></author><author><name sortKey="Marmont, A" sort="Marmont, A" uniqKey="Marmont A" first="A." last="Marmont">A. Marmont</name><affiliation wicri:level="1"><inist:fA14 i1="14"><s1>Ospedale San Martino</s1><s2>Genova</s2><s3>ITA</s3><sZ>15 aut.</sZ></inist:fA14><country>Italie</country><wicri:noRegion>Ospedale San Martino</wicri:noRegion></affiliation></author><author><name sortKey="Moore, J" sort="Moore, J" uniqKey="Moore J" first="J." last="Moore">J. Moore</name><affiliation wicri:level="3"><inist:fA14 i1="15"><s1>St Vincents Hospital</s1><s2>Sydney</s2><s3>AUS</s3><sZ>16 aut.</sZ></inist:fA14><country>Australie</country><placeName><settlement type="city">Sydney</settlement><region type="état">Nouvelle-Galles du Sud</region></placeName></affiliation></author><author><name sortKey="Saccardi, R" sort="Saccardi, R" uniqKey="Saccardi R" first="R." last="Saccardi">R. Saccardi</name><affiliation wicri:level="1"><inist:fA14 i1="16"><s1>Ospedale di Careggi</s1><s2>Florence</s2><s3>ITA</s3><sZ>17 aut.</sZ></inist:fA14><country>Italie</country><wicri:noRegion>Ospedale di Careggi</wicri:noRegion></affiliation></author><author><name sortKey="Snowden, J A" sort="Snowden, J A" uniqKey="Snowden J" first="J. A." last="Snowden">J. A. Snowden</name><affiliation wicri:level="1"><inist:fA14 i1="17"><s1>Sheffield Teaching Hospitals NHS Trust</s1><s2>Sheffield</s2><s3>GBR</s3><sZ>18 aut.</sZ></inist:fA14><country>Royaume-Uni</country><wicri:noRegion>Sheffield Teaching Hospitals NHS Trust</wicri:noRegion></affiliation></author><author><name sortKey="Van Den Hoogen, F" sort="Van Den Hoogen, F" uniqKey="Van Den Hoogen F" first="F." last="Van Den Hoogen">F. Van Den Hoogen</name><affiliation wicri:level="3"><inist:fA14 i1="18"><s1>University Medical Center St Radboud</s1><s2>Nijmegen</s2><s3>NLD</s3><sZ>19 aut.</sZ></inist:fA14><country>Pays-Bas</country><placeName><settlement type="city">Nimègue</settlement><region type="province" nuts="2">Gueldre</region></placeName></affiliation></author><author><name sortKey="Wulffraat, N M" sort="Wulffraat, N M" uniqKey="Wulffraat N" first="N. M." last="Wulffraat">N. M. Wulffraat</name><affiliation wicri:level="3"><inist:fA14 i1="19"><s1>University Hospital for Children</s1><s2>Utrecht</s2><s3>NLD</s3><sZ>20 aut.</sZ></inist:fA14><country>Pays-Bas</country><placeName><settlement type="city">Utrecht</settlement><region nuts="2" type="province">Utrecht (province)</region></placeName></affiliation></author><author><name sortKey="Zhao, X W" sort="Zhao, X W" uniqKey="Zhao X" first="X. W." last="Zhao">X. W. Zhao</name><affiliation wicri:level="1"><inist:fA14 i1="20"><s1>The Third People Hospital of Zhengzhou</s1><s2>Zhengzhou</s2><s3>CHN</s3><sZ>21 aut.</sZ></inist:fA14><country>République populaire de Chine</country><wicri:noRegion>The Third People Hospital of Zhengzhou</wicri:noRegion></affiliation></author><author><name sortKey="Tyndall, A" sort="Tyndall, A" uniqKey="Tyndall A" first="A." last="Tyndall">A. Tyndall</name><affiliation wicri:level="1"><inist:fA14 i1="02"><s1>Stem Cell Transplant Team, Department of Rheumatology, University Basel, Felix Platter Spital</s1><s2>Basel</s2><s3>CHE</s3><sZ>3 aut.</sZ><sZ>22 aut.</sZ></inist:fA14><country>Suisse</country><wicri:noRegion>Basel</wicri:noRegion></affiliation></author></analytic><series><title level="j" type="main">Bone marrow transplantation : (Basingstoke)</title><title level="j" type="abbreviated">Bone marrow transplant. : (Basingstoke)</title><idno type="ISSN">0268-3369</idno><imprint><date when="2005">2005</date></imprint></series></biblStruct></sourceDesc><seriesStmt><title level="j" type="main">Bone marrow transplantation : (Basingstoke)</title><title level="j" type="abbreviated">Bone marrow transplant. : (Basingstoke)</title><idno type="ISSN">0268-3369</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Autograft</term><term>Autoimmune disease</term><term>Hematology</term><term>Hematopoietic cell</term><term>Immunosuppression</term><term>Stem cell</term><term>Survival</term><term>Treatment</term></keywords><keywords scheme="Pascal" xml:lang="fr"><term>Autogreffe</term><term>Cellule hématopoïétique</term><term>Cellule souche</term><term>Maladie autoimmune</term><term>Immunodépression</term><term>Survie</term><term>Traitement</term><term>Hématologie</term></keywords><keywords scheme="Wicri" type="topic" xml:lang="fr"><term>Cellule souche</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Experimental data and early phase I/II studies suggest that high-dose chemotherapy followed by autologous hematopoietic stem cell transplantation (HSCT) can arrest progression of severe autoimmune diseases. We have evaluated the toxicity and disease response in 473 patients with severe autoimmune disease treated with autologous HSCT between 1995 and 2003, from 110 centers participating in the European Group for Blood and Marrow Transplantation (EBMT) autoimmune disease working party database. Survival, transplant-related mortality, treatment response and disease progression were assessed. In all, 420 patients (89%; 86±4% at 3 years, median follow-up 20 months) were alive, 53 (11%) had died from transplant-related mortality (N=31; 7±3% at 3 years) or disease progression (N= 22; 9±4% at 3 years). Of 370 patients, 299 evaluable for response (81%) showed a treatment response, which was sustained in 213 (71% of responders). Response was associated with disease (P<0.001), was better in patients who received cyclophosphamide during mobilization (relative risk (RR)3.28 (1.57-6.83)) and was worse with increasing age (>40 years, RR0.29 (0.11-0.82)). Disease progression was associated with disease (P<0.001) and conditioning intensity (high intensity, RR1; intermediate intensity, RR1.81 (0.96-3.42)); low intensity, RR2.34 (1.074-5.11)). These data from the collective EBMT experience support the hypothesis that autologous HSCT can alter disease progression in severe autoimmune disease.</div></front></TEI><affiliations><list><country><li>Allemagne</li><li>Australie</li><li>Espagne</li><li>France</li><li>Grèce</li><li>Italie</li><li>Pays-Bas</li><li>Royaume-Uni</li><li>Russie</li><li>République populaire de Chine</li><li>République tchèque</li><li>Suisse</li></country><region><li>Bade-Wurtemberg</li><li>Berlin</li><li>Bohême centrale</li><li>Catalogne</li><li>District de Fribourg-en-Brisgau</li><li>District de Tübingen</li><li>Gueldre</li><li>Hollande-Méridionale</li><li>Nouvelle-Galles du Sud</li><li>Utrecht (province)</li><li>Île-de-France</li></region><settlement><li>Barcelone</li><li>Berlin</li><li>Fribourg-en-Brisgau</li><li>Leyde</li><li>Nimègue</li><li>Paris</li><li>Prague</li><li>Rotterdam</li><li>Sydney</li><li>Tübingen</li><li>Utrecht</li></settlement></list><tree><country name="Suisse"><noRegion><name sortKey="Gratwohl, A" sort="Gratwohl, A" uniqKey="Gratwohl A" first="A." last="Gratwohl">A. Gratwohl</name></noRegion><name sortKey="Bocelli Tyndall, C" sort="Bocelli Tyndall, C" uniqKey="Bocelli Tyndall C" first="C." last="Bocelli-Tyndall">C. Bocelli-Tyndall</name><name sortKey="Passweg, J" sort="Passweg, J" uniqKey="Passweg J" first="J." last="Passweg">J. Passweg</name><name sortKey="Tyndall, A" sort="Tyndall, A" uniqKey="Tyndall A" first="A." last="Tyndall">A. Tyndall</name></country><country name="Grèce"><noRegion><name sortKey="Fassas, A" sort="Fassas, A" uniqKey="Fassas A" first="A." last="Fassas">A. Fassas</name></noRegion></country><country name="Pays-Bas"><region name="Hollande-Méridionale"><name sortKey="Van Laar, J M" sort="Van Laar, J M" uniqKey="Van Laar J" first="J. M." last="Van Laar">J. M. Van Laar</name></region><name sortKey="Lowenberg, B" sort="Lowenberg, B" uniqKey="Lowenberg B" first="B." last="Löwenberg">B. Löwenberg</name><name sortKey="Van Den Hoogen, F" sort="Van Den Hoogen, F" uniqKey="Van Den Hoogen F" first="F." last="Van Den Hoogen">F. Van Den Hoogen</name><name sortKey="Wulffraat, N M" sort="Wulffraat, N M" uniqKey="Wulffraat N" first="N. M." last="Wulffraat">N. M. Wulffraat</name></country><country name="France"><region name="Île-de-France"><name sortKey="Farge, D" sort="Farge, D" uniqKey="Farge D" first="D." last="Farge">D. Farge</name></region></country><country name="Italie"><noRegion><name sortKey="Andolina, M" sort="Andolina, M" uniqKey="Andolina M" first="M." last="Andolina">M. Andolina</name></noRegion><name sortKey="Marmont, A" sort="Marmont, A" uniqKey="Marmont A" first="A." last="Marmont">A. Marmont</name><name sortKey="Saccardi, R" sort="Saccardi, R" uniqKey="Saccardi R" first="R." last="Saccardi">R. Saccardi</name></country><country name="Allemagne"><region name="Berlin"><name sortKey="Arnold, R" sort="Arnold, R" uniqKey="Arnold R" first="R." last="Arnold">R. Arnold</name></region><name sortKey="Finke, J" sort="Finke, J" uniqKey="Finke J" first="J." last="Finke">J. Finke</name><name sortKey="Kotter, I" sort="Kotter, I" uniqKey="Kotter I" first="I." last="Kötter">I. Kötter</name></country><country name="Espagne"><region name="Catalogne"><name sortKey="Carreras, E" sort="Carreras, E" uniqKey="Carreras E" first="E." last="Carreras">E. Carreras</name></region></country><country name="République tchèque"><region name="Bohême centrale"><name sortKey="Kozak, T" sort="Kozak, T" uniqKey="Kozak T" first="T." last="Kozak">T. Kozak</name></region></country><country name="Russie"><noRegion><name sortKey="Lisukov, I" sort="Lisukov, I" uniqKey="Lisukov I" first="I." last="Lisukov">I. Lisukov</name></noRegion></country><country name="Australie"><region name="Nouvelle-Galles du Sud"><name sortKey="Moore, J" sort="Moore, J" uniqKey="Moore J" first="J." last="Moore">J. Moore</name></region></country><country name="Royaume-Uni"><noRegion><name sortKey="Snowden, J A" sort="Snowden, J A" uniqKey="Snowden J" first="J. A." last="Snowden">J. A. Snowden</name></noRegion></country><country name="République populaire de Chine"><noRegion><name sortKey="Zhao, X W" sort="Zhao, X W" uniqKey="Zhao X" first="X. W." last="Zhao">X. W. Zhao</name></noRegion></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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