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Autologous hematopoietic stem cell transplantation for autoimmune diseases

Identifieur interne : 004733 ( PascalFrancis/Checkpoint ); précédent : 004732; suivant : 004734

Autologous 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 :

RBID : Pascal:05-0217360

Descripteurs français

English descriptors

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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Pascal:05-0217360

Le document en format XML

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<name sortKey="Zhao, X W" sort="Zhao, X W" uniqKey="Zhao X" first="X. W." last="Zhao">X. W. Zhao</name>
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<title xml:lang="en" level="a">Autologous hematopoietic stem cell transplantation for autoimmune diseases</title>
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<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>
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<name sortKey="Farge, D" sort="Farge, D" uniqKey="Farge D" first="D." last="Farge">D. Farge</name>
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<name sortKey="Andolina, M" sort="Andolina, M" uniqKey="Andolina M" first="M." last="Andolina">M. Andolina</name>
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<name sortKey="Arnold, R" sort="Arnold, R" uniqKey="Arnold R" first="R." last="Arnold">R. Arnold</name>
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<name sortKey="Carreras, E" sort="Carreras, E" uniqKey="Carreras E" first="E." last="Carreras">E. Carreras</name>
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<s1>Hospital Clinic</s1>
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<name sortKey="Finke, J" sort="Finke, J" uniqKey="Finke J" first="J." last="Finke">J. Finke</name>
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<s1>Klinikum der Albert-Ludwigs Universität Freiburg</s1>
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<country>Allemagne</country>
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<name sortKey="Kotter, I" sort="Kotter, I" uniqKey="Kotter I" first="I." last="Kötter">I. Kötter</name>
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<s1>Medizinische Universitdtsklinik</s1>
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<country>Allemagne</country>
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<region type="land" nuts="1">Bade-Wurtemberg</region>
<region type="district" nuts="2">District de Tübingen</region>
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<name sortKey="Lowenberg, B" sort="Lowenberg, B" uniqKey="Lowenberg B" first="B." last="Löwenberg">B. Löwenberg</name>
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<name sortKey="Saccardi, R" sort="Saccardi, R" uniqKey="Saccardi R" first="R." last="Saccardi">R. Saccardi</name>
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<name sortKey="Snowden, J A" sort="Snowden, J A" uniqKey="Snowden J" first="J. A." last="Snowden">J. A. Snowden</name>
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<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>
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<name sortKey="Zhao, X W" sort="Zhao, X W" uniqKey="Zhao X" first="X. W." last="Zhao">X. W. Zhao</name>
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<s1>The Third People Hospital of Zhengzhou</s1>
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<sZ>22 aut.</sZ>
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<country>Suisse</country>
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<title level="j" type="main">Bone marrow transplantation : (Basingstoke)</title>
<title level="j" type="abbreviated">Bone marrow transplant. : (Basingstoke)</title>
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<title level="j" type="main">Bone marrow transplantation : (Basingstoke)</title>
<title level="j" type="abbreviated">Bone marrow transplant. : (Basingstoke)</title>
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<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>
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<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>
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<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>
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<s0>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.</s0>
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<li>Berlin</li>
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<li>District de Tübingen</li>
<li>Gueldre</li>
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<li>Île-de-France</li>
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<li>Berlin</li>
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<li>Prague</li>
<li>Rotterdam</li>
<li>Sydney</li>
<li>Tübingen</li>
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<name sortKey="Farge, D" sort="Farge, D" uniqKey="Farge D" first="D." last="Farge">D. Farge</name>
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<name sortKey="Arnold, R" sort="Arnold, R" uniqKey="Arnold R" first="R." last="Arnold">R. Arnold</name>
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<name sortKey="Carreras, E" sort="Carreras, E" uniqKey="Carreras E" first="E." last="Carreras">E. Carreras</name>
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