Experience of successful autologous hematopoietic stem cell transplantation in patients with an unfavorable prognosis of systemic scleroderma
V. I. Mazurov,
A. L. Maslyanskiy,
K. E. Zotkina,
S. S. Benevolenskaya,
D. V. Motorin,
A. Yu. Zaritskiy,
E. A. Vasilenko,
A. A. Vasilenko,
A. M. Titova https://doi.org/10.47360/1995-4484-2022-381-387
Abstract
One of the methods of treating severe forms of systemic scleroderma is hematopoietic stem-cell autotransplantation (auto-HSCT). The article describes two clinical cases of auto-HSCT followed by rituximab (RTM) therapy in patients with diffuse systemic scleroderma with progressive interstitial lung disease (ILD), high immunological activity, high skin score, and an unfavorable prognosis. The assessment of the course of these diseases was carried out in the course of dynamic observation of patients for 10–11 years. In all cases, auto-HSCT followed by RTM made it possible to achieve remission / low activity, as well as to stabilize the progressive of ILD.
About the Authors
V. I. Mazurov
North-Western State Medical University named after I.I. Mechnikov
Russian Federation
Russian Federation
191015, Saint Petersburg, Kirochnaya str., 41
A. L. Maslyanskiy
Almazov National Medical Research Centre
Russian Federation
Russian Federation
197341, Saint Petersburg, Akkuratova str., 2
K. E. Zotkina
Almazov National Medical Research Centre
Russian Federation
Russian Federation
197341, Saint Petersburg, Akkuratova str., 2
S. S. Benevolenskaya
Almazov National Medical Research Centre
Russian Federation
Russian Federation
197341, Saint Petersburg, Akkuratova str., 2
D. V. Motorin
Almazov National Medical Research Centre
Russian Federation
Russian Federation
197341, Saint Petersburg, Akkuratova str., 2
A. Yu. Zaritskiy
Almazov National Medical Research Centre
Russian Federation
Russian Federation
197341, Saint Petersburg, Akkuratova str., 2
E. A. Vasilenko
North-Western State Medical University named after I.I. Mechnikov
Russian Federation
Russian Federation
191015, Saint Petersburg, Kirochnaya str., 41
A. A. Vasilenko
Novgorod Regional Clinical Hospital
Russian Federation
Russian Federation
173008, Veliky Novgorod, Pavla Levitta str., 14
A. M. Titova
Almazov National Medical Research Centre
Russian Federation
Russian Federation
197341, Saint Petersburg, Akkuratova str., 2
References
1. Steen VD, Medsger TA. Changes in causes of death in systemic sclerosis, 1972–2002. Ann Rheum Dis. 2007;66(7):940-944. doi: 10.1136/ard.2006.066068
2. Goldin JG, Kim GHJ, Tseng CH, Volkmann E, Furst D, Clements P, et al. Longitudinal changes in quantitative interstitial lung disease on computed tomography after immunosuppression in the Scleroderma Lung Study II. Ann Am Thorac Soc. 2018;15(11):1286-1295. doi: 10.1513/AnnalsATS.201802-079OC
3. Giuggioli D, Lumetti F, Colaci M, Fallahi P, Antonelli A, Ferri C. Rituximab in the treatment of patients with systemic sclerosis. Our experience and review of the literature. Autoimmun Rev. 2015;14(11):1072-1078. doi: 10.1016/j.autrev.2015.07.008
4. Zacay G, Levy Y. Outcomes of patients with systemic sclerosis treated with tocilizumab: Case series and review of the literature. Best Pract Res Clin Rheumatol. 2018;32(4):563-571. doi: 10.1016/j.berh.2019.01.011
5. Avdeev SN, Ananyeva LP, Zhilyaev EV, Zonova EV, Klimenko AA, Koneva OA, et al. The resolution of the Expert Council on Interstitial Lung Diseases in Systemic Scleroderma (Moscow, October 14, 2019). Modern Rheumatology Journal. 2020;14(1):125-128 (In Russ.). doi: 10.14412/1996-7012-2020-1-125-128
6. Novik AA, Bogdanov AN. Principles of bone marrow and peripheral blood stem cell transplantation. Saint Petersburg:Voenno-meditsinskaya akademiya;2001 (In Russ.).
7. European Society for Blood and Marrow Transplantation. Transplant activity survey. URL: https://www.ebmt.org/registry/ transplant-activity-survey (Accessed: DD Month 2022).
8. Burt RK, Shah SJ, Dill K, Grant T, Gheorghiade M, Schroeder J, et al. Autologous non-myeloablative haemopoietic stem-cell transplantation compared with pulse cyclophosphamide once per month for systemic sclerosis (ASSIST): An open-label, randomised phase 2 trial. Lancet. 2011;378(9790):498-506. doi: 10.1016/S0140-6736(11)60982-3
9. van Laar JM, Farge D, Sont JK, Naraghi K, Marjanovic Z, Larghero J, et al.; EBMT/EULAR Scleroderma Study Group. Autologous hematopoietic stem cell transplantation vs intravenous pulse cyclophosphamide in diffuse cutaneous systemic sclerosis: A randomized clinical trial. JAMA. 2014;311(24):2490-2498. doi: 10.1001/jama.2014.6368
10. Sullivan KM, Goldmuntz EA, Keyes-Elstein L, McSweeney PA, Pinckney A, Welch B, et al.; SCOT Study Investigators. Myeloablative autologous stem-cell transplantation for severe scleroderma. N Engl J Med. 2018;378(1):35-47. doi: 10.1056/nejmoa1703327
11. Farge D. Stem cell transplantation for systemic sclerosis in Israel: A new star is rising. Isr Med Assoc J. 2020;22(2):116-118.
12. Kowal-Bielecka O, Fransen J, Avouac J, Becker M, Kulak A, Allanore Y, et al.; EUSTAR Coauthors. Update of EULAR recommendations for the treatment of systemic sclerosis. Ann Rheum Dis. 2017;76(8):1327-1339. doi: 10.1136/annrheumdis-2016-209909
13. Masliansky AL, Mazurov VI, Zotkin EG, Ilivanova EP, Totolian AA. Anti-B cell therapy of autoimmune diseases. Medical Immunology (Russia). 2007;9(1):15-34 (In Russ.). doi: 10.15789/1563-0625-2007-1-15-34
Review
For citations:
Mazurov V.I., Maslyanskiy A.L., Zotkina K.E., Benevolenskaya S.S., Motorin D.V., Zaritskiy A.Yu., Vasilenko E.A., Vasilenko A.A., Titova A.M. Experience of successful autologous hematopoietic stem cell transplantation in patients with an unfavorable prognosis of systemic scleroderma. Rheumatology Science and Practice. 2022;60(3):381-387. (In Russ.) https://doi.org/10.47360/1995-4484-2022-381-387
Views:
873
Email this article 