Disappearance of lupus anticoagulant after allogeneic bone marrow transplantation

Olalla, JI; Ortín, Miguel; Hermida, Gerardo; Baró, J; Sedano, Carmen; Morante, Carlos; Zubizarreta, A

doi:10.1038/sj.bmt.1701516

Cited by 26 publications

(8 citation statements)

References 10 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…15 Disappearance of the lupus anticoagulant has also been reported in a chronic myeloid leukemia patient who received allogeneic HSCT. 16 However, this is the first case to show decreased aCL titers and improved clinical symptoms of APS after autologous HSCT. The present case suggests the efficacy of autologous HSCT for patients with refractory APS.…”

Section: Discussionmentioning

confidence: 99%

Autologous hematopoietic stem cell transplantation for refractory antiphospholipid syndrome causing myocardial necrosis

Hashimoto

Iwasaki

Sekiguchi

et al. 2004

Bone Marrow Transplant

View full text Add to dashboard Cite

Summary:Autologous hematopoietic stem cell transplantation (HSCT) is currently being evaluated as a treatment for autoimmune diseases, including systemic lupus erythematosus (SLE), that are associated with a very severe prognosis. We describe a 27-year-old woman with SLE with a 10-year history of refractory antiphospholipid syndrome (APS). She developed progressive myocardial necrosis despite treatment with corticosteroids, cyclophosphamide (CYC), cyclosporine, and immunopheresis. After conditioning with CYC, fludarabine, and antithymocyte globulin, autologous HSCT using CD34 þ selection was performed. After transplantation, the clinical symptoms caused by APS remitted, and the serum anticardiolipin antibody level decreased. Remission has persisted for 21 months after transplantation. Although a longer follow-up is required for the assessment of efficacy, autologous HSCT may cure patients with refractory APS.

show abstract

Section: Discussionmentioning

confidence: 99%

Autologous hematopoietic stem cell transplantation for refractory antiphospholipid syndrome causing myocardial necrosis

Hashimoto

Iwasaki

Sekiguchi

et al. 2004

Bone Marrow Transplant

View full text Add to dashboard Cite

show abstract

“…Early animal models showed the effectiveness of SCT in APS. 3 This observation was not translated to clinical practice until the end of the 1990s when Olalla et al 22 reported the first case of disappearance of LA Abs in a patient without SLE treated with allogeneic SCT for chronic myeloid leukemia. Most reported studies described SCT for APS secondary to SLE.…”

Section: Discussion and Review Of Literaturementioning

confidence: 99%

Successful treatment of a case of catastrophic antiphospholipid syndrome with autologous BMT: case report and review of literature

Owaidah

Maghrabi

Elkarouri

et al. 2010

Bone Marrow Transplant

View full text Add to dashboard Cite

“…Also, disappearance of a lupus anticoagulant following allogeneic BMT in a patient with no clinical evidence of SLE has been described in the medical literature. 9 Rauch et al, 10 described that immunization of mice with phosphatidylethanolamine (PE) in the hexagonal II phase, but not the bilayer phase, resulted in the induction of anti-phospholipid antibodies. 10 Similarly, hexagonal (II) PE is specifically recognized by lupus anticoagulant antibodies in SLE patients and may play a role in the etiology of the disease.…”

Section: Discussionmentioning

confidence: 99%

Acute graft-versus-host disease (aGVHD) presenting with an acquired lupus anticoagulant

Kharfan-Dabaja

Morgensztern

Santos

et al. 2003

Bone Marrow Transplant

View full text Add to dashboard Cite

Summary:There are few reports describing the association between antiphospholipid antibodies, including the lupus anticoagulant, and bone marrow or peripheral stem cell transplantation. Autoimmune syndromes and autoantibodies such as lupus anticoagulant and anticardiolipin antibodies have been described following allogeneic bone marrow or peripheral blood stem cell transplantation, particularly in patients who develop chronic graft-versushost disease (GVHD). The association between Lupus anticoagulant and acute GVHD has not been previously described. We report a patient who developed a de novo lupus anticoagulant on day +34 after a matched-related allogeneic peripheral stem cell transplant. No clinical evidence of systemic thrombosis was observed and the lupus anticoagulant disappeared following immunosuppressive therapy with a combination of steroids and infliximab. Bone Marrow Transplantation (2003) 31, 129-131. doi:10.1038/sj.bmt.1703794 Keywords: lupus anticoagulant; acute GVHD; bone marrow transplantation; peripheral stem cell transplantation When allogeneic bone marrow or peripheral stem cells are the source of stem cells, donor-derived T cells recognize and react to histoincompatible recipient antigens and cells, a phenomenon that forms the basis for the development of graft-versus-host disease (GVHD). 1 GVHD remains a major complication of allogeneic bone marrow and peripheral stem cell transplantation (BM/PSCT). Autoimmune syndromes and autoantibodies including lupus anticoagulant and anticardiolipin antibodies have been described following allogeneic BM/PSCT, particularly in patients who develop chronic GVHD. 2,3 The lupus anticoagulant is an antibody that binds to a complex of anionic phospholipid-bound prothrombin, resulting in prolongation of phospholipid-dependent clotting times. 4 Newly acquired lupus anticoagulant has been reported in association with chronic GVHD, 5 but not with acute GVHD (aGVHD). We report a case of an acquired lupus anticoagulant that developed on day +34 after a matchedrelated allogeneic peripheral stem cell transplant. Case reportA 28-year-old man diagnosed with aplastic anemia received a matched-related allogeneic PSCT. The conditioning regimen included cyclophosphamide at a daily dose of 50 mg/ kg on days À5 to À2 and antithymocyte globulin (ATG) at a dose of 30 mg/kg administered on days À4 to À2, given 12 h after cyclophosphamide. Immunosuppression consisted of tacrolimus at a dose of 0.03 mg/kg daily and methotrexate at a dose of 10 mg/m 2 on day +1 and 5 mg/m 2 on days +3, +6 and +11. The patient's immediate post-transplant course was uneventful with engraftment on day +16 and discharge from the unit on day +24. The patient presented to the bone marrow transplant unit on day +34 with symptoms suggestive of gastrointestinal aGVHD including abdominal pain and bloody diarrhea. Biopsy of the colon confirmed the diagnosis. Additional laboratory examination disclosed an isolated prolongation of the aPTT of 82.7 s (normal range: 23.8-32.2 s). The baseline value of the patien...

show abstract

Disappearance of lupus anticoagulant after allogeneic bone marrow transplantation

Cited by 26 publications

References 10 publications

Autologous hematopoietic stem cell transplantation for refractory antiphospholipid syndrome causing myocardial necrosis

Autologous hematopoietic stem cell transplantation for refractory antiphospholipid syndrome causing myocardial necrosis

Successful treatment of a case of catastrophic antiphospholipid syndrome with autologous BMT: case report and review of literature

Acute graft-versus-host disease (aGVHD) presenting with an acquired lupus anticoagulant

Contact Info

Product

Resources

About