Treatment and follow‐up of 18 severe systemic lupus erythematosus patients with stem cell transplantation
Identifieur interne : 002A98 ( Istex/Curation ); précédent : 002A97; suivant : 002A99Treatment and follow‐up of 18 severe systemic lupus erythematosus patients with stem cell transplantation
Auteurs : Xiaomei Leng ; Yan Zhao ; Daobing Zhou [République populaire de Chine] ; Xinping Tian ; Taisheng Li [République populaire de Chine] ; Ti Shen [République populaire de Chine] ; Yongqiang Zhao [République populaire de Chine] ; Xiaofeng Zeng ; Fengchun Zhang ; Yi Dong ; Fulin TangSource :
- APLAR Journal of Rheumatology [ 0219-0494 ] ; 2006-04.
English descriptors
- Teeft :
- Antidsdna antibody, Aplar, Aplar journal, Arthritis rheum, Autoimmune, Autoimmune disease, Autoimmune diseases, Autologous, Biopsy, Cell selection, Cell transplantation, College hospital, Conventional therapy, Disease activity, Erythematosus, Farr method, Immune, Immune reconstitution, Immunosuppressive therapy, Lupus, Nephropathy, Neutrophil count, Overall remission rate, Pbsct, Peking, Peking union, Peripheral blood, Pred, Reconstitution, Relapse, Remission, Renal, Renal biopsy, Rheumatology, Sledai, Sledai scores, Systemic lupus erythematosus, Transplantation, Upro.
Abstract
Aim: To investigate the feasibility, efficacy and safety of high‐dose immunosuppressive therapy and autologous peripheral blood stem cell transplantation (PBSCT) with CD34+ cell selection in patients with refractory and severe autoimmune diseases. Methods: Eighteen patients with persistent systemic lupus erythematosus refractory to conventional treatment were enrolled into the study of peripheral blood stem cell transplantation in Peking Union Medical College Hospital from 1999 to 2005. After mobilization and conditioning, the enriched CD34+ cells were reinfused. Disease activity, adverse effects, haematopoietic and immunologic reconstitution were monitored and followed up for at least 6 months. Results: Overall treatment‐related mortality was 5.6% with one patient dying of cytomegalovirus infection. The overall remission rate was 95.8% in the first year after PBSCT. Relapse occurred in three patients (17.6%) in 37, 26, and 19 months post‐transplantation, respectively. Disease Activity Index scores of systemic lupus erythematosus survivors were decreased significantly (P < 0.001). Conclusions: Short‐term effect of autologous peripheral blood stem cell transplantation is promising although treatment‐related mortality and relapses are observed in a subset of patients. High‐dose immunosuppressive therapy followed by autologous peripheral blood stem cell transplantation with CD34+ cell selection is feasible and relatively safe in the treatment of severe and refractory autoimmune diseases. The long‐term effect needs further evaluation and multicentre study.
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DOI: 10.1111/j.1479-8077.2006.00164.x
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Xiaomei Leng<affiliation><mods:affiliation>Department of Rheumatology, Peking Union Medical College Hospital, Beijing,</mods:affiliation><wicri:noCountry code="subField"></wicri:noCountry></affiliation><affiliation><mods:affiliation>Department of Rheumatology, Peking Union Medical College Hospital, Beijing,</mods:affiliation><wicri:noCountry code="subField"></wicri:noCountry></affiliation><affiliation><mods:affiliation>Department of Rheumatology, Peking Union Medical College Hospital, Beijing,</mods:affiliation><wicri:noCountry code="subField"></wicri:noCountry></affiliation><affiliation><mods:affiliation>Department of Rheumatology, Peking Union Medical College Hospital, Beijing,</mods:affiliation><wicri:noCountry code="subField"></wicri:noCountry></affiliation><affiliation><mods:affiliation>Department of Rheumatology, Peking Union Medical College Hospital, Beijing,</mods:affiliation><wicri:noCountry code="subField"></wicri:noCountry></affiliation><affiliation><mods:affiliation>Department of Rheumatology, Peking Union Medical College Hospital, Beijing,</mods:affiliation><wicri:noCountry code="subField"></wicri:noCountry></affiliation><affiliation><mods:affiliation>Department of Rheumatology, Peking Union Medical College Hospital, Beijing,</mods:affiliation><wicri:noCountry code="subField"></wicri:noCountry></affiliation>Le document en format XML
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wicri:level="3"><mods:affiliation>Department of Hematology, Peking Union Medical College Hospital, Beijing and</mods:affiliation><country>République populaire de Chine</country><placeName><settlement type="city">Pékin</settlement></placeName><wicri:orgArea>Department of Hematology, Peking Union Medical College Hospital</wicri:orgArea></affiliation></author><author><name sortKey="Tian, Xinping" sort="Tian, Xinping" uniqKey="Tian X" first="Xinping" last="Tian">Xinping Tian</name><affiliation><mods:affiliation>Department of Rheumatology, Peking Union Medical College Hospital, Beijing,</mods:affiliation><wicri:noCountry code="subField"></wicri:noCountry></affiliation></author><author><name sortKey="Li, Taisheng" sort="Li, Taisheng" uniqKey="Li T" first="Taisheng" last="Li">Taisheng Li</name><affiliation wicri:level="3"><mods:affiliation>Department of Infectious diseases, Peking Union Medical College Hospital, Beijing</mods:affiliation><country>République populaire de Chine</country><placeName><settlement type="city">Pékin</settlement></placeName><wicri:orgArea>Department of Infectious diseases, Peking Union Medical College Hospital</wicri:orgArea></affiliation></author><author><name sortKey="Shen, Ti" sort="Shen, Ti" uniqKey="Shen T" first="Ti" last="Shen">Ti Shen</name><affiliation wicri:level="3"><mods:affiliation>Department of Hematology, Peking Union Medical College Hospital, Beijing and</mods:affiliation><country>République populaire de Chine</country><placeName><settlement type="city">Pékin</settlement></placeName><wicri:orgArea>Department of Hematology, Peking Union Medical College Hospital</wicri:orgArea></affiliation></author><author><name sortKey="Zhao, Yongqiang" sort="Zhao, Yongqiang" uniqKey="Zhao Y" first="Yongqiang" last="Zhao">Yongqiang Zhao</name><affiliation wicri:level="3"><mods:affiliation>Department of Hematology, Peking Union Medical College Hospital, Beijing and</mods:affiliation><country>République populaire de Chine</country><placeName><settlement type="city">Pékin</settlement></placeName><wicri:orgArea>Department of Hematology, Peking Union Medical College Hospital</wicri:orgArea></affiliation></author><author><name sortKey="Zeng, Xiaofeng" sort="Zeng, Xiaofeng" uniqKey="Zeng X" first="Xiaofeng" last="Zeng">Xiaofeng Zeng</name><affiliation><mods:affiliation>Department of Rheumatology, Peking Union Medical College Hospital, Beijing,</mods:affiliation><wicri:noCountry code="subField"></wicri:noCountry></affiliation></author><author><name sortKey="Zhang, Fengchun" sort="Zhang, Fengchun" uniqKey="Zhang F" first="Fengchun" last="Zhang">Fengchun Zhang</name><affiliation><mods:affiliation>Department of Rheumatology, Peking Union Medical College Hospital, Beijing,</mods:affiliation><wicri:noCountry code="subField"></wicri:noCountry></affiliation></author><author><name sortKey="Dong, Yi" sort="Dong, Yi" uniqKey="Dong Y" first="Yi" last="Dong">Yi Dong</name><affiliation><mods:affiliation>Department of Rheumatology, Peking Union Medical College Hospital, Beijing,</mods:affiliation><wicri:noCountry code="subField"></wicri:noCountry></affiliation></author><author><name sortKey="Tang, Fulin" sort="Tang, Fulin" uniqKey="Tang F" first="Fulin" last="Tang">Fulin Tang</name><affiliation><mods:affiliation>Department of Rheumatology, Peking Union Medical College Hospital, Beijing,</mods:affiliation><wicri:noCountry code="subField"></wicri:noCountry></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">ISTEX</idno><idno type="RBID">ISTEX:98382DFE9A6FA9DBB84987B3925813D8F91567CF</idno><date when="2006" year="2006">2006</date><idno type="doi">10.1111/j.1479-8077.2006.00164.x</idno><idno type="url">https://api.istex.fr/ark:/67375/WNG-CVLL18Q5-4/fulltext.pdf</idno><idno type="wicri:Area/Istex/Corpus">002A98</idno><idno type="wicri:explorRef" wicri:stream="Istex" wicri:step="Corpus" wicri:corpus="ISTEX">002A98</idno><idno type="wicri:Area/Istex/Curation">002A98</idno></publicationStmt><sourceDesc><biblStruct><analytic><title level="a" type="main">Treatment and follow‐up of 18 severe systemic lupus erythematosus patients with stem cell transplantation</title><author><name sortKey="Leng, Xiaomei" sort="Leng, Xiaomei" uniqKey="Leng X" first="Xiaomei" last="Leng">Xiaomei Leng</name><affiliation><mods:affiliation>Department of Rheumatology, Peking Union Medical College Hospital, Beijing,</mods:affiliation><wicri:noCountry code="subField"></wicri:noCountry></affiliation></author><author><name sortKey="Zhao, Yan" sort="Zhao, Yan" uniqKey="Zhao Y" first="Yan" last="Zhao">Yan Zhao</name><affiliation><mods:affiliation>Department of Rheumatology, Peking Union Medical College Hospital, Beijing,</mods:affiliation><wicri:noCountry code="subField"></wicri:noCountry></affiliation></author><author><name sortKey="Zhou, Daobing" sort="Zhou, Daobing" uniqKey="Zhou D" first="Daobing" last="Zhou">Daobing Zhou</name><affiliation wicri:level="3"><mods:affiliation>Department of Hematology, Peking Union Medical College Hospital, Beijing and</mods:affiliation><country>République populaire de Chine</country><placeName><settlement type="city">Pékin</settlement></placeName><wicri:orgArea>Department of Hematology, Peking Union Medical College Hospital</wicri:orgArea></affiliation></author><author><name sortKey="Tian, Xinping" sort="Tian, Xinping" uniqKey="Tian X" first="Xinping" last="Tian">Xinping Tian</name><affiliation><mods:affiliation>Department of Rheumatology, Peking Union Medical College Hospital, Beijing,</mods:affiliation><wicri:noCountry code="subField"></wicri:noCountry></affiliation></author><author><name sortKey="Li, Taisheng" sort="Li, Taisheng" uniqKey="Li T" first="Taisheng" last="Li">Taisheng Li</name><affiliation wicri:level="3"><mods:affiliation>Department of Infectious diseases, Peking Union Medical College Hospital, Beijing</mods:affiliation><country>République populaire de Chine</country><placeName><settlement type="city">Pékin</settlement></placeName><wicri:orgArea>Department of Infectious diseases, Peking Union Medical College Hospital</wicri:orgArea></affiliation></author><author><name sortKey="Shen, Ti" sort="Shen, Ti" uniqKey="Shen T" first="Ti" last="Shen">Ti Shen</name><affiliation wicri:level="3"><mods:affiliation>Department of Hematology, Peking Union Medical College Hospital, Beijing and</mods:affiliation><country>République populaire de Chine</country><placeName><settlement type="city">Pékin</settlement></placeName><wicri:orgArea>Department of Hematology, Peking Union Medical College Hospital</wicri:orgArea></affiliation></author><author><name sortKey="Zhao, Yongqiang" sort="Zhao, Yongqiang" uniqKey="Zhao Y" first="Yongqiang" last="Zhao">Yongqiang Zhao</name><affiliation wicri:level="3"><mods:affiliation>Department of Hematology, Peking Union Medical College Hospital, Beijing and</mods:affiliation><country>République populaire de Chine</country><placeName><settlement type="city">Pékin</settlement></placeName><wicri:orgArea>Department of Hematology, Peking Union Medical College Hospital</wicri:orgArea></affiliation></author><author><name sortKey="Zeng, Xiaofeng" sort="Zeng, Xiaofeng" uniqKey="Zeng X" first="Xiaofeng" last="Zeng">Xiaofeng Zeng</name><affiliation><mods:affiliation>Department of Rheumatology, Peking Union Medical College Hospital, Beijing,</mods:affiliation><wicri:noCountry code="subField"></wicri:noCountry></affiliation></author><author><name sortKey="Zhang, Fengchun" sort="Zhang, Fengchun" uniqKey="Zhang F" first="Fengchun" last="Zhang">Fengchun Zhang</name><affiliation><mods:affiliation>Department of Rheumatology, Peking Union Medical College Hospital, Beijing,</mods:affiliation><wicri:noCountry code="subField"></wicri:noCountry></affiliation></author><author><name sortKey="Dong, Yi" sort="Dong, Yi" uniqKey="Dong Y" first="Yi" last="Dong">Yi Dong</name><affiliation><mods:affiliation>Department of Rheumatology, Peking Union Medical College Hospital, Beijing,</mods:affiliation><wicri:noCountry code="subField"></wicri:noCountry></affiliation></author><author><name sortKey="Tang, Fulin" sort="Tang, Fulin" uniqKey="Tang F" first="Fulin" last="Tang">Fulin Tang</name><affiliation><mods:affiliation>Department of Rheumatology, Peking Union Medical College Hospital, Beijing,</mods:affiliation><wicri:noCountry code="subField"></wicri:noCountry></affiliation></author></analytic><monogr></monogr><series><title level="j" type="main">APLAR Journal of Rheumatology</title><title level="j" type="alt">APLAR JOURNAL OF RHEUMATOLOGY</title><idno type="ISSN">0219-0494</idno><idno type="eISSN">1479-8077</idno><imprint><biblScope unit="vol">9</biblScope><biblScope unit="issue">1</biblScope><biblScope unit="page" from="49">49</biblScope><biblScope unit="page" to="55">55</biblScope><biblScope unit="page-count">7</biblScope><publisher>Blackwell Publishing Asia</publisher><pubPlace>Melbourne, Australia</pubPlace><date type="published" when="2006-04">2006-04</date></imprint><idno type="ISSN">0219-0494</idno></series></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0219-0494</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="Teeft" xml:lang="en"><term>Antidsdna antibody</term><term>Aplar</term><term>Aplar journal</term><term>Arthritis rheum</term><term>Autoimmune</term><term>Autoimmune disease</term><term>Autoimmune diseases</term><term>Autologous</term><term>Biopsy</term><term>Cell selection</term><term>Cell transplantation</term><term>College hospital</term><term>Conventional therapy</term><term>Disease activity</term><term>Erythematosus</term><term>Farr method</term><term>Immune</term><term>Immune reconstitution</term><term>Immunosuppressive therapy</term><term>Lupus</term><term>Nephropathy</term><term>Neutrophil count</term><term>Overall remission rate</term><term>Pbsct</term><term>Peking</term><term>Peking union</term><term>Peripheral blood</term><term>Pred</term><term>Reconstitution</term><term>Relapse</term><term>Remission</term><term>Renal</term><term>Renal biopsy</term><term>Rheumatology</term><term>Sledai</term><term>Sledai scores</term><term>Systemic lupus erythematosus</term><term>Transplantation</term><term>Upro</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Aim: To investigate the feasibility, efficacy and safety of high‐dose immunosuppressive therapy and autologous peripheral blood stem cell transplantation (PBSCT) with CD34+ cell selection in patients with refractory and severe autoimmune diseases. Methods: Eighteen patients with persistent systemic lupus erythematosus refractory to conventional treatment were enrolled into the study of peripheral blood stem cell transplantation in Peking Union Medical College Hospital from 1999 to 2005. After mobilization and conditioning, the enriched CD34+ cells were reinfused. Disease activity, adverse effects, haematopoietic and immunologic reconstitution were monitored and followed up for at least 6 months. Results: Overall treatment‐related mortality was 5.6% with one patient dying of cytomegalovirus infection. The overall remission rate was 95.8% in the first year after PBSCT. Relapse occurred in three patients (17.6%) in 37, 26, and 19 months post‐transplantation, respectively. Disease Activity Index scores of systemic lupus erythematosus survivors were decreased significantly (P < 0.001). Conclusions: Short‐term effect of autologous peripheral blood stem cell transplantation is promising although treatment‐related mortality and relapses are observed in a subset of patients. High‐dose immunosuppressive therapy followed by autologous peripheral blood stem cell transplantation with CD34+ cell selection is feasible and relatively safe in the treatment of severe and refractory autoimmune diseases. The long‐term effect needs further evaluation and multicentre study.</div></front></TEI></record>Pour manipuler ce document sous Unix (Dilib)
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