Complications of autologous hematopoietic stem cell transplantation for patients with autoimmune diseases

Autologous haematopoietic stem cell transplantation (AHSCT) is a multistep procedure that enables destruction of the immune system and its reconstitution from haematopoietic stem cells. Originally developed for the treatment of haematological malignancies, the procedure has been adapted for the treatment of severe immune-mediated disorders. Results from ~20 years of research make a compelling case for selective use of AHSCT in patients with highly active multiple sclerosis (MS), and for controlled trials. Immunological studies support the notion that AHSCT causes qualitative immune resetting, and have provided insight into the mechanisms that might underlie the powerful treatment effects that last well beyond recovery of immune cell numbers. Indeed, studies have demonstrated that AHSCT can entirely suppress MS disease activity for 4–5 years in 70–80% of patients, a rate that is higher than those achieved with any other therapies for MS. Treatment-related mortality, which was 3.6% in studies before 2005, has decreased to 0.3% in studies since 2005. Current evidence indicates that the patients who are most likely to benefit from and tolerate AHSCT are young, ambulatory and have inflammatory MS activity. Clinical trials are required to rigorously test the efficacy, safety and cost-effectiveness of AHSCT against highly active MS drugs

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“…Further detail about the complications of AHSCT for the treatment of autoimmune disease is available elsewhere 70 .…”

Section: [H2] Safety and Tolerabilitymentioning

confidence: 99%

Autologous haematopoietic stem cell transplantation for treatment of multiple sclerosis

et al. 2017

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“…Complications associated with autologous HSCT include preparative regimen-related organ toxicity, opportunistic infections, infertility, recurrence of disease, and secondary malignancies (29). Autologous transplant-related mortality is approximately 3-5% for patients with myeloma and lymphoma and approximately 5-10% for those with scleroderma (23, 27, 30, 31).…”

Section: The Process Of Autologous Hsctmentioning

confidence: 99%

Review: Hematopoietic Stem Cell Transplantation for Scleroderma: Effective Immunomodulatory Therapy for Patients With Pulmonary Involvement

Sullivan

Shah

Sarantopoulos

et al. 2016

Arthritis & Rheumatology

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“…However, there were complications of hematopoietic stem cells transplantation in the treatment of autoimmune diseases, which included availability, treatment-related mortality, infective and endocrinological complications, treatmentassociated toxicity, and secondary autoimmune diseases and malignancies (71,72). MSCs, on the contrary, could represent a future treatment, with a possible safe and tolerable profile, for inflammatory arthritis such as SpAs.…”

Section: Reviewmentioning

confidence: 99%

Mesenchimal stem cells: a possible role in the pathogenesis and treatment of spondyloarthritis

et al. 2017

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SUMMARY Spondyloarthritis (SpAs) are a group of chronic inflammatory diseases that affect joints and enthesis with a possible involvement of other districts such as skin, eye and bowel. In SpAs, the inflammatory process could lead to both erosive damage (as in peripheral joint involvement of psoriatic arthritis), or bone formation (as in ankylosing spondylitis) with a reduction in function and quality of life. Recently, Mesenchimal stem cells (MSCs) transplant was used in different diseases, including autoimmune and inflammatory diseases, with the aim of repairing tissue damage, exploiting their regenerative capacity. However, MSCs also proved to have an immune-modulatory capacity due to their interaction with the cells of the immune system. The aim of this brief paper was to review the possible pathogenic role and the new perspective of MSCs use in SpAs.

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Complications of autologous hematopoietic stem cell transplantation for patients with autoimmune diseases

Cited by 69 publications

References 45 publications

Autologous haematopoietic stem cell transplantation for treatment of multiple sclerosis

Autologous haematopoietic stem cell transplantation for treatment of multiple sclerosis

Review: Hematopoietic Stem Cell Transplantation for Scleroderma: Effective Immunomodulatory Therapy for Patients With Pulmonary Involvement

Mesenchimal stem cells: a possible role in the pathogenesis and treatment of spondyloarthritis

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