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Allogeneic HSCT for Autoimmune Diseases: A Retrospective Study From the EBMT ADWP, IEWP, and PDWP Working Parties.
- Source :
-
Frontiers in immunology [Front Immunol] 2019 Jul 04; Vol. 10, pp. 1570. Date of Electronic Publication: 2019 Jul 04 (Print Publication: 2019). - Publication Year :
- 2019
-
Abstract
- Background: This retrospective study assessed the use and long-term outcome of allogeneic hematopoietic stem cell transplantation (HSCT) in patients with severe autoimmune diseases (ADs), reported to the European Society for Blood and Marrow Transplantation (EBMT) registry. Methods: Between 1997 and 2014, 128 patients received allogeneic HSCT for various hematological ( n = 49) and non-hematological ( n = 79) refractory ADs. The median age was 12.7 years (0.2-62.2). Donors were syngeneic for seven, matched related for 46, unrelated for 51, haploidentical for 15, and cord blood for nine patients. Results: The incidence of grades II-IV acute graft-vs.-host disease (GvHD) was 20.8% at 100 days. Cumulative incidence of chronic GvHD was 27.8% at 5-years. Non-relapse mortality (NRM) was 12.7% at 100-days. Overall survival (OS) and Progression-Free Survival (PFS) were 70.2 and 59.4% at 5-years, respectively. By multivariate analysis, age <18 years, males, and more recent year of transplant were found to be significantly associated with improved PFS. Reduced conditioning intensity was associated with a lower NRM. On a subgroup of 64 patients with detailed information a complete clinical response was obtained in 67% of patients at 1-year. Conclusions: This large EBMT survey suggests the potential of allogeneic HSCT to induce long-term disease control in a large proportion of refractory ADs, with acceptable toxicities and NRM, especially in younger patients.
- Subjects :
- Acute Disease
Adolescent
Adult
Age Factors
Allografts
Child
Child, Preschool
Female
Humans
Incidence
Infant
Male
Middle Aged
Retrospective Studies
Sex Factors
Autoimmune Diseases epidemiology
Autoimmune Diseases immunology
Autoimmune Diseases therapy
Graft vs Host Disease epidemiology
Graft vs Host Disease immunology
Hematopoietic Stem Cell Transplantation
Transplantation Conditioning
Subjects
Details
- Language :
- English
- ISSN :
- 1664-3224
- Volume :
- 10
- Database :
- MEDLINE
- Journal :
- Frontiers in immunology
- Publication Type :
- Academic Journal
- Accession number :
- 31333680
- Full Text :
- https://doi.org/10.3389/fimmu.2019.01570