Treatment of severe systemic lupus erythematosus with high-dose chemotherapy and haemopoietic stem-cell transplantation: a phase I study
Identifieur interne : 002436 ( Main/Exploration ); précédent : 002435; suivant : 002437Treatment of severe systemic lupus erythematosus with high-dose chemotherapy and haemopoietic stem-cell transplantation: a phase I study
Auteurs : Ann E. Traynor [États-Unis] ; James Schroeder [États-Unis] ; Robert M. Rosa [États-Unis] ; Dong Cheng [États-Unis] ; Jakub Stefka [États-Unis] ; Salim Mujais [États-Unis] ; Steven Baker [États-Unis] ; Richard K. Burt [États-Unis]Source :
- The Lancet [ 0140-6736 ] ; 2000.
English descriptors
- Teeft :
- Abnormality, Absolute neutrophil count, Active disease, Active lupus, Antihypertensive agents, Antinuclear antibody, Antithymocyte globulin, Arthritis rheum, Articles patient, August, Autoimmune disease, Autoimmune diseases, Autologous, Autologous haemopoietic transplantation, Autologous transplantation, Bone marrow transplantation, Cell transplantation, Chronic headache, Class glomerulonephritis, Clinical evidence, Conditioning regimen, Continuous hyperfiltration, Creatinine clearance, Cyclophosphamide, Daily doses, Disease activity, Disease onset, Eligible patients, Erythematosus, Flow cytometry, Fluid overload, Haemoglobin, Haemopoietic, Immune, Immune suppression, Immune system, Interleukin, Intracellular interleukin, Intravenous, Intravenous cyclophosphamide, James schroeder, Lancet, Life technologies, Lupus, Lupus erythematosus, Lupus nephritis, Lymphocyte, Magnetic resonance imaging, Median, Median time, Normal control, Northwestern memorial hospital, Northwestern university, Oedema, Peripheral blood, Peripheral blood lymphocytes, Perkin elmer cetus, Proc natl acad, Repertoire, Salim mujais, Steven baker, Systemic, Systemic lupus erythematosus, Systemic lupus erythematosus disease activity index scores, Transplant, Transplantation, Transverse myelitis, Vital capacity.
Abstract
Summary: Background Patients with systemic lupus erythematosus (SLE) who experience persistent multiorgan dysfunction, despite standard doses of intravenous cyclophosphamide, represent a subset of patients at high risk of early death. We investigated the safety and efficacy of immune suppression and autologous haemopoietic stem-cell infusion to treat such patients.Methods From 1996, we selected patients with persistent SLE despite use of cyclophosphamide. Patients underwent dose-intense immune suppression and autologous haemopoietic stem-cell (CD34) infusion. Peripheral blood lymphocytes were analysed by flow cytometry, ELISA, and T-cell-receptor spectratyping before and after transplantation. We mobilised autologous haemopoietic stem cells with 20 g/m2 cyclophosphamide and 10 g/kg granulocyte colony stimulating factor daily, enriched with CD34-positive selection, and reinfused after immunosuppression with 200 mg/kg cyclophosphamide, 1 g methylprednisolone, and 90 mg/kg equine antithymocyte globulin.Results Nine patients underwent stem-cell mobilisation but two were excluded before transplantation because of infection. The remaining seven received high-dose chemotherapy and stem-cell infusion. Median time to an absolute neutrophil count higher than 05109/L and non-transfused platelet count higher than 20109/L was 9 days (range 811) and 11 days (1013), respectively. At a median follow-up of 25 months (1240), all patients were free from signs of active lupus. Renal, cardiac, pulmonary, and serological markers, and T-cell phenotype and repertoire had normalised.Interpretation Patients remained free from active lupus and improved continuously after tranplantation, with no immunosuppressive medication or small residual doses of prednisone. T-cell repertoire diversity and responsiveness was restored. Durability of remission remains to be established.
Url:
DOI: 10.1016/S0140-6736(00)02627-1
Affiliations:
Links toward previous steps (curation, corpus...)
- to stream Istex, to step Corpus: 001C34
- to stream Istex, to step Curation: 001C34
- to stream Istex, to step Checkpoint: 001251
- to stream Main, to step Merge: 002463
- to stream Main, to step Curation: 002436
Le document en format XML
<record><TEI wicri:istexFullTextTei="biblStruct"><teiHeader><fileDesc><titleStmt><title>Treatment of severe systemic lupus erythematosus with high-dose chemotherapy and haemopoietic stem-cell transplantation: a phase I study</title><author><name sortKey="Traynor, Ann E" sort="Traynor, Ann E" uniqKey="Traynor A" first="Ann E" last="Traynor">Ann E. Traynor</name></author><author><name sortKey="Schroeder, James" sort="Schroeder, James" uniqKey="Schroeder J" first="James" last="Schroeder">James Schroeder</name></author><author><name sortKey="Rosa, Robert M" sort="Rosa, Robert M" uniqKey="Rosa R" first="Robert M" last="Rosa">Robert M. Rosa</name></author><author><name sortKey="Cheng, Dong" sort="Cheng, Dong" uniqKey="Cheng D" first="Dong" last="Cheng">Dong Cheng</name></author><author><name sortKey="Stefka, Jakub" sort="Stefka, Jakub" uniqKey="Stefka J" first="Jakub" last="Stefka">Jakub Stefka</name></author><author><name sortKey="Mujais, Salim" sort="Mujais, Salim" uniqKey="Mujais S" first="Salim" last="Mujais">Salim Mujais</name></author><author><name sortKey="Baker, Steven" sort="Baker, Steven" uniqKey="Baker S" first="Steven" last="Baker">Steven Baker</name></author><author><name sortKey="Burt, Richard K" sort="Burt, Richard K" uniqKey="Burt R" first="Richard K" last="Burt">Richard K. Burt</name></author></titleStmt><publicationStmt><idno type="wicri:source">ISTEX</idno><idno type="RBID">ISTEX:816816DAD01C26F32E391D816A15D846F48FEF79</idno><date when="2000" year="2000">2000</date><idno type="doi">10.1016/S0140-6736(00)02627-1</idno><idno type="url">https://api.istex.fr/ark:/67375/6H6-BWKPC2J0-C/fulltext.pdf</idno><idno type="wicri:Area/Istex/Corpus">001C34</idno><idno type="wicri:explorRef" wicri:stream="Istex" wicri:step="Corpus" wicri:corpus="ISTEX">001C34</idno><idno type="wicri:Area/Istex/Curation">001C34</idno><idno type="wicri:Area/Istex/Checkpoint">001251</idno><idno type="wicri:explorRef" wicri:stream="Istex" wicri:step="Checkpoint">001251</idno><idno type="wicri:doubleKey">0140-6736:2000:Traynor A:treatment:of:severe</idno><idno type="wicri:Area/Main/Merge">002463</idno><idno type="wicri:Area/Main/Curation">002436</idno><idno type="wicri:Area/Main/Exploration">002436</idno></publicationStmt><sourceDesc><biblStruct><analytic><title level="a">Treatment of severe systemic lupus erythematosus with high-dose chemotherapy and haemopoietic stem-cell transplantation: a phase I study</title><author><name sortKey="Traynor, Ann E" sort="Traynor, Ann E" uniqKey="Traynor A" first="Ann E" last="Traynor">Ann E. Traynor</name><affiliation wicri:level="1"><country wicri:rule="url">États-Unis</country></affiliation><affiliation wicri:level="2"><country xml:lang="fr">États-Unis</country><wicri:regionArea>Robert H Lurie Cancer Center, Division of Immunotherapy for Autoimmune Diseases, Northwestern University, Chicago, IL</wicri:regionArea><placeName><region type="state">Illinois</region></placeName></affiliation></author><author><name sortKey="Schroeder, James" sort="Schroeder, James" uniqKey="Schroeder J" first="James" last="Schroeder">James Schroeder</name><affiliation wicri:level="3"><country>États-Unis</country><placeName><settlement type="city">Chicago</settlement><region type="state">Illinois</region></placeName><wicri:orgArea>Division Of Rheumatology, Department Of Medicine, Northwestern University Medical School</wicri:orgArea></affiliation></author><author><name sortKey="Rosa, Robert M" sort="Rosa, Robert M" uniqKey="Rosa R" first="Robert M" last="Rosa">Robert M. Rosa</name><affiliation wicri:level="3"><country>États-Unis</country><placeName><settlement type="city">Chicago</settlement><region type="state">Illinois</region></placeName><wicri:orgArea>Division Of Nephrology, Department Of Medicine, Northwestern University Medical School</wicri:orgArea></affiliation></author><author><name sortKey="Cheng, Dong" sort="Cheng, Dong" uniqKey="Cheng D" first="Dong" last="Cheng">Dong Cheng</name><affiliation wicri:level="2"><country xml:lang="fr">États-Unis</country><wicri:regionArea>Robert H Lurie Cancer Center, Division of Immunotherapy for Autoimmune Diseases, Northwestern University, Chicago, IL</wicri:regionArea><placeName><region type="state">Illinois</region></placeName></affiliation></author><author><name sortKey="Stefka, Jakub" sort="Stefka, Jakub" uniqKey="Stefka J" first="Jakub" last="Stefka">Jakub Stefka</name><affiliation wicri:level="2"><country xml:lang="fr">États-Unis</country><wicri:regionArea>Robert H Lurie Cancer Center, Division of Immunotherapy for Autoimmune Diseases, Northwestern University, Chicago, IL</wicri:regionArea><placeName><region type="state">Illinois</region></placeName></affiliation></author><author><name sortKey="Mujais, Salim" sort="Mujais, Salim" uniqKey="Mujais S" first="Salim" last="Mujais">Salim Mujais</name><affiliation wicri:level="3"><country>États-Unis</country><placeName><settlement type="city">Chicago</settlement><region type="state">Illinois</region></placeName><wicri:orgArea>Division Of Nephrology, Department Of Medicine, Northwestern University Medical School</wicri:orgArea></affiliation></author><author><name sortKey="Baker, Steven" sort="Baker, Steven" uniqKey="Baker S" first="Steven" last="Baker">Steven Baker</name><affiliation wicri:level="3"><country>États-Unis</country><placeName><settlement type="city">Chicago</settlement><region type="state">Illinois</region></placeName><wicri:orgArea>Division Of Pulmonary Medicine, Department Of Medicine, Northwestern University Medical School</wicri:orgArea></affiliation></author><author><name sortKey="Burt, Richard K" sort="Burt, Richard K" uniqKey="Burt R" first="Richard K" last="Burt">Richard K. Burt</name><affiliation wicri:level="2"><country xml:lang="fr">États-Unis</country><wicri:regionArea>Robert H Lurie Cancer Center, Division of Immunotherapy for Autoimmune Diseases, Northwestern University, Chicago, IL</wicri:regionArea><placeName><region type="state">Illinois</region></placeName></affiliation></author></analytic><monogr></monogr><series><title level="j">The Lancet</title><title level="j" type="abbrev">LANCET</title><idno type="ISSN">0140-6736</idno><imprint><publisher>ELSEVIER</publisher><date type="published" when="2000">2000</date><biblScope unit="volume">356</biblScope><biblScope unit="issue">9231</biblScope><biblScope unit="page" from="701">701</biblScope><biblScope unit="page" to="707">707</biblScope></imprint><idno type="ISSN">0140-6736</idno></series></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0140-6736</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="Teeft" xml:lang="en"><term>Abnormality</term><term>Absolute neutrophil count</term><term>Active disease</term><term>Active lupus</term><term>Antihypertensive agents</term><term>Antinuclear antibody</term><term>Antithymocyte globulin</term><term>Arthritis rheum</term><term>Articles patient</term><term>August</term><term>Autoimmune disease</term><term>Autoimmune diseases</term><term>Autologous</term><term>Autologous haemopoietic transplantation</term><term>Autologous transplantation</term><term>Bone marrow transplantation</term><term>Cell transplantation</term><term>Chronic headache</term><term>Class glomerulonephritis</term><term>Clinical evidence</term><term>Conditioning regimen</term><term>Continuous hyperfiltration</term><term>Creatinine clearance</term><term>Cyclophosphamide</term><term>Daily doses</term><term>Disease activity</term><term>Disease onset</term><term>Eligible patients</term><term>Erythematosus</term><term>Flow cytometry</term><term>Fluid overload</term><term>Haemoglobin</term><term>Haemopoietic</term><term>Immune</term><term>Immune suppression</term><term>Immune system</term><term>Interleukin</term><term>Intracellular interleukin</term><term>Intravenous</term><term>Intravenous cyclophosphamide</term><term>James schroeder</term><term>Lancet</term><term>Life technologies</term><term>Lupus</term><term>Lupus erythematosus</term><term>Lupus nephritis</term><term>Lymphocyte</term><term>Magnetic resonance imaging</term><term>Median</term><term>Median time</term><term>Normal control</term><term>Northwestern memorial hospital</term><term>Northwestern university</term><term>Oedema</term><term>Peripheral blood</term><term>Peripheral blood lymphocytes</term><term>Perkin elmer cetus</term><term>Proc natl acad</term><term>Repertoire</term><term>Salim mujais</term><term>Steven baker</term><term>Systemic</term><term>Systemic lupus erythematosus</term><term>Systemic lupus erythematosus disease activity index scores</term><term>Transplant</term><term>Transplantation</term><term>Transverse myelitis</term><term>Vital capacity</term></keywords></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="abstract">Summary: Background Patients with systemic lupus erythematosus (SLE) who experience persistent multiorgan dysfunction, despite standard doses of intravenous cyclophosphamide, represent a subset of patients at high risk of early death. We investigated the safety and efficacy of immune suppression and autologous haemopoietic stem-cell infusion to treat such patients.Methods From 1996, we selected patients with persistent SLE despite use of cyclophosphamide. Patients underwent dose-intense immune suppression and autologous haemopoietic stem-cell (CD34) infusion. Peripheral blood lymphocytes were analysed by flow cytometry, ELISA, and T-cell-receptor spectratyping before and after transplantation. We mobilised autologous haemopoietic stem cells with 20 g/m2 cyclophosphamide and 10 g/kg granulocyte colony stimulating factor daily, enriched with CD34-positive selection, and reinfused after immunosuppression with 200 mg/kg cyclophosphamide, 1 g methylprednisolone, and 90 mg/kg equine antithymocyte globulin.Results Nine patients underwent stem-cell mobilisation but two were excluded before transplantation because of infection. The remaining seven received high-dose chemotherapy and stem-cell infusion. Median time to an absolute neutrophil count higher than 05109/L and non-transfused platelet count higher than 20109/L was 9 days (range 811) and 11 days (1013), respectively. At a median follow-up of 25 months (1240), all patients were free from signs of active lupus. Renal, cardiac, pulmonary, and serological markers, and T-cell phenotype and repertoire had normalised.Interpretation Patients remained free from active lupus and improved continuously after tranplantation, with no immunosuppressive medication or small residual doses of prednisone. T-cell repertoire diversity and responsiveness was restored. Durability of remission remains to be established.</div></front></TEI><affiliations><list><country><li>États-Unis</li></country><region><li>Illinois</li></region><settlement><li>Chicago</li></settlement></list><tree><country name="États-Unis"><noRegion><name sortKey="Traynor, Ann E" sort="Traynor, Ann E" uniqKey="Traynor A" first="Ann E" last="Traynor">Ann E. Traynor</name></noRegion><name sortKey="Baker, Steven" sort="Baker, Steven" uniqKey="Baker S" first="Steven" last="Baker">Steven Baker</name><name sortKey="Burt, Richard K" sort="Burt, Richard K" uniqKey="Burt R" first="Richard K" last="Burt">Richard K. Burt</name><name sortKey="Cheng, Dong" sort="Cheng, Dong" uniqKey="Cheng D" first="Dong" last="Cheng">Dong Cheng</name><name sortKey="Mujais, Salim" sort="Mujais, Salim" uniqKey="Mujais S" first="Salim" last="Mujais">Salim Mujais</name><name sortKey="Rosa, Robert M" sort="Rosa, Robert M" uniqKey="Rosa R" first="Robert M" last="Rosa">Robert M. Rosa</name><name sortKey="Schroeder, James" sort="Schroeder, James" uniqKey="Schroeder J" first="James" last="Schroeder">James Schroeder</name><name sortKey="Stefka, Jakub" sort="Stefka, Jakub" uniqKey="Stefka J" first="Jakub" last="Stefka">Jakub Stefka</name><name sortKey="Traynor, Ann E" sort="Traynor, Ann E" uniqKey="Traynor A" first="Ann E" last="Traynor">Ann E. Traynor</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
EXPLOR_STEP=$WICRI_ROOT/Sante/explor/ChloroquineV1/Data/Main/Exploration
HfdSelect -h $EXPLOR_STEP/biblio.hfd -nk 002436 | SxmlIndent | more
Ou
HfdSelect -h $EXPLOR_AREA/Data/Main/Exploration/biblio.hfd -nk 002436 | SxmlIndent | more
Pour mettre un lien sur cette page dans le réseau Wicri
{{Explor lien
|wiki= Sante
|area= ChloroquineV1
|flux= Main
|étape= Exploration
|type= RBID
|clé= ISTEX:816816DAD01C26F32E391D816A15D846F48FEF79
|texte= Treatment of severe systemic lupus erythematosus with high-dose chemotherapy and haemopoietic stem-cell transplantation: a phase I study
}}
| This area was generated with Dilib version V0.6.33. |  |