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Secondary autoimmune diseases occurring after HSCT for an autoimmune disease: a retrospective study of the EBMT Autoimmune Disease Working Party
- Source :
- Blood, 118(6), 1693-1698, Blood, Blood, American Society of Hematology, 2011, 118 (6), pp.1693-8. ⟨10.1182/blood-2011-02-336156⟩, Blood, 2011, 118 (6), pp.1693-8. ⟨10.1182/blood-2011-02-336156⟩
- Publication Year :
- 2011
-
Abstract
- To specify the incidence and risk factors for secondary autoimmune diseases (ADs) after HSCT for a primary AD, we retrospectively analyzed AD patients treated by HSCT reported to EBMT from 1995 to 2009 with at least 1 secondary AD (cases) and those without (controls). After autologous HSCT, 29 of 347 patients developed at least 1 secondary AD within 21.9 (0.6-49) months and after allogeneic HSCT, 3 of 16 patients. The observed secondary ADs included: autoimmune hemolytic anemia (n = 3), acquired hemophilia (n = 3), autoimmune thrombocytopenia (n = 3), antiphospholipid syndrome (n = 2), thyroiditis (n = 12), blocking thyroid-stimulating hormone receptor antibody (n = 1), Graves disease (n = 2), myasthenia gravis (n = 1), rheumatoid arthritis (n = 2), sarcoidosis (n = 2), vasculitis (n = 1), psoriasis (n = 1), and psoriatic arthritis (n = 1). After autologous HSCT for primary AD, the cumulative incidence of secondary AD was 9.8% ± 2% at 5 years. Lupus erythematosus as primary AD, and antithymocyte globulin use plus CD34+ graft selection were important risk factors for secondary AD by multivariate analysis. With a median follow-up of 6.2 (0.54-11) years after autologous HSCT, 26 of 29 patients with secondary AD were alive, 2 died during their secondary AD (antiphospholipid syndrome, hemophilia), and 1 death was HSCT-related. This European multicenter study underlines the need for careful management and follow-up for secondary AD after HSCT.
- Subjects :
- Male
stem-cell transplantation bone-marrow-transplantation hemolytic-anemia blood
medicine.medical_treatment
Hematopoietic stem cell transplantation
Biochemistry
Autoimmune thrombocytopenia
Antibodies, Monoclonal, Murine-Derived
0302 clinical medicine
Prednisone
immune system diseases
Risk Factors
hemic and lymphatic diseases
Child
Hematopoietic Stem Cell Transplantation
[SDV.MHEP.HEM]Life Sciences [q-bio]/Human health and pathology/Hematology
Hematology
Middle Aged
3. Good health
Europe
surgical procedures, operative
Treatment Outcome
030220 oncology & carcinogenesis
Child, Preschool
Rituximab
Female
Autoimmune hemolytic anemia
Immunosuppressive Agents
medicine.drug
Adult
medicine.medical_specialty
Adolescent
Immunology
Autoimmune Diseases
03 medical and health sciences
Young Adult
Antiphospholipid syndrome
Internal medicine
medicine
Humans
Immunologic Factors
Cyclophosphamide
Glucocorticoids
Retrospective Studies
Autoimmune disease
Lupus erythematosus
business.industry
Infant
Cell Biology
[SDV.IMM.IMM]Life Sciences [q-bio]/Immunology/Immunotherapy
medicine.disease
Multivariate Analysis
business
030215 immunology
Subjects
Details
- ISSN :
- 15280020 and 00064971
- Volume :
- 118
- Issue :
- 6
- Database :
- OpenAIRE
- Journal :
- Blood
- Accession number :
- edsair.doi.dedup.....b96f19405f6e2eb28339717573f9243b