Autologous hematopoietic stem cell transplant for progressive diffuse systemic sclerosis: procedural success and clinical outcome in 5-year follow-up

Abstract

Systemic sclerosis is an autoimmune connective tissue disease affecting both skin and internal organs. Progressive disease with multiple organ involvement is considered to have a poor prognosis. Treatment possibilities are limited, but certain patients may benefit from autologous hematopoietic stem cell transplantation (auto-HSCT).We report a case of a 30-year-old woman with progressive diffuse systemic sclerosis treated with parenteral cyclophosphamide with unsatisfactory results. Due to progression of the disease and lack of alternative therapies auto-HSCT was performed.After instituting treatment with autologous hematopoietic stem cell transplantation no immunosuppressive therapy has been required during 5-year follow-up. Improvement in exertion tolerance, partial regression of skin lesions and stabilization of pulmonary and cardiovascular changes were observed. Currently therapeutic options in patients with progressive systemic sclerosis are limited. Hematopoietic stem cell transplantation might become an alternative therapeutic solution not only in the early phase of the disease but also among selected patients with progressive systemic sclerosis resistant to standard therapy.

Improvement of rosacea by injection of platelet-rich plasma

“…Both human bone aspirate concentrates and PRP containing CD34 + cells had similar therapeutic effects on bone regeneration [9]. The CD34 + hematopoietic stem cell is currently under investigation as a treatment for severe autoimmune diseases like alopecia universalis [6] and systemic sclerosis [10]. That study suggests the possibility of treating autoimmune diseases by the eradication of autoreactive cells.…”

Autologous hematopoietic stem cell transplantation in systemic sclerosis patientss

“…Pawlak-Bus, et al, reported recently the clinical outcome of a 5-year follow-up of a SScl patient that underwent AHSCT. The patient showed an improvement in exertion tolerance, partial regression of skin lesions and stabilization of pulmonary and cardiovascular changes [10]. Finally, in 2018, the American Society for Blood and Marrow Transplantation (ASBMR), based on high-quality evidence, recommended that AHSCT should be considered as a "standard of care" indication for SScl patients [11].…”

Stem Cell Therapies in Systemic Sclerosis: An Updated Review

“…The most typical symptoms of SSc emerge from dermal and vascular lesions [30]. Pulmonary fibrosis and pulmonary artery hypertension are the leading causes of death in patients with SSc as pulmonary complications of SSc are one of the most challenging complications of SSc [18,31].…”