Treatment and follow‐up of 18 severe systemic lupus erythematosus patients with stem cell transplantation
Identifieur interne : 001C38 ( Main/Exploration ); précédent : 001C37; suivant : 001C39Treatment 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.
Url:
DOI: 10.1111/j.1479-8077.2006.00164.x
Affiliations:
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Le document en format XML
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<term>Autoimmune diseases</term>
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<term>Biopsy</term>
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<term>Cell transplantation</term>
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<term>Disease activity</term>
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<term>Immunosuppressive therapy</term>
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<term>Peking union</term>
<term>Peripheral blood</term>
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<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>
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<name sortKey="Zeng, Xiaofeng" sort="Zeng, Xiaofeng" uniqKey="Zeng X" first="Xiaofeng" last="Zeng">Xiaofeng Zeng</name>
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