Autologous haematopoietic stem cell transplants for autoimmune disease - Feasibility and transplant-related mortality

A. Tyndall, A. Fassas, J. Passweg, C. Ruiz De Elvira, M. Attal, P. Brooks, C. Black, P. Durez, J. Finke, S. Forman, L. Fouillard, D. Furst, J. A. Holmes, D. Joske, J. P. Jouet, I. Kötter, F. Locatelli, H. G. Prentice, A. M. Marmont, P. McSweeney & 9 others M. Musso, H. H. Peter, J. A. Snowden, K. Sullivan, A. Tichelli, J. Vavriec, N. M. Wulffraat, N. Schmitz, A. Gratwohl

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Abstract

This ongoing multicentre prospective phase I/II trial enrolled 74 consecutive patients from 22 centres worldwide with severe autoimmune disease, 35 with rheumatological disorders, 31 with neurological, five with haematological and three with vasculitides. They were treated with autologous peripheral blood or bone marrow transplants according to predetermined criteria. Two patients died after mobilisation before transplant. Seventy-two patients were given 73 transplants, seven bone marrow; and 66 mobilised peripheral blood stem cell transplants. The graft was manipulated to remove T and/or B cells in 43 cases. All 73 transplants engrafted. Five patients died of transplant-related complications: two from bleeding, three from infections, Two patients died of progressive disease. The transplant-related mortality at 1 year of 9% (1-17%; 95% CI) is comparable to the transplant-related mortality of 6% (3-9%; 95% CI) in patients transplanted during the same period in Europe for non-Hodgkin's lymphoma in sensitive relapse (P = 0.39). Sixty patients are evaluable for response, 40 patients (65%) showed some improvement in their disease. Haematopoietic stem cell transplants are feasible for patients with severe refractory autoimmune disease. Transplant-related mortality is comparable to results in patients with non-Hodgkin's lymphoma in responsive relapse. Two-thirds of the patients show at least some response. These preliminary data are promising. Although associated with considerable risk, randomised trials comparing autologous stem cell transplants to conventional therapy are warranted.

Original languageEnglish
Pages (from-to)729-734
Number of pages6
JournalBone Marrow Transplantation
Volume24
Issue number7
Publication statusPublished - 1999

Fingerprint

Hematopoietic Stem Cells
Autoimmune Diseases
Transplants
Mortality
Non-Hodgkin's Lymphoma
Bone Marrow
Recurrence
Vasculitis
B-Lymphocytes
Stem Cells
Hemorrhage
T-Lymphocytes

Keywords

  • Autoimmune disease
  • Bone marrow
  • Mortality
  • Stem cell
  • Toxicity

ASJC Scopus subject areas

  • Hematology
  • Transplantation

Cite this

Tyndall, A., Fassas, A., Passweg, J., Ruiz De Elvira, C., Attal, M., Brooks, P., ... Gratwohl, A. (1999). Autologous haematopoietic stem cell transplants for autoimmune disease - Feasibility and transplant-related mortality. Bone Marrow Transplantation, 24(7), 729-734.

Autologous haematopoietic stem cell transplants for autoimmune disease - Feasibility and transplant-related mortality. / Tyndall, A.; Fassas, A.; Passweg, J.; Ruiz De Elvira, C.; Attal, M.; Brooks, P.; Black, C.; Durez, P.; Finke, J.; Forman, S.; Fouillard, L.; Furst, D.; Holmes, J. A.; Joske, D.; Jouet, J. P.; Kötter, I.; Locatelli, F.; Prentice, H. G.; Marmont, A. M.; McSweeney, P.; Musso, M.; Peter, H. H.; Snowden, J. A.; Sullivan, K.; Tichelli, A.; Vavriec, J.; Wulffraat, N. M.; Schmitz, N.; Gratwohl, A.

In: Bone Marrow Transplantation, Vol. 24, No. 7, 1999, p. 729-734.

Research output: Contribution to journalArticle

Tyndall, A, Fassas, A, Passweg, J, Ruiz De Elvira, C, Attal, M, Brooks, P, Black, C, Durez, P, Finke, J, Forman, S, Fouillard, L, Furst, D, Holmes, JA, Joske, D, Jouet, JP, Kötter, I, Locatelli, F, Prentice, HG, Marmont, AM, McSweeney, P, Musso, M, Peter, HH, Snowden, JA, Sullivan, K, Tichelli, A, Vavriec, J, Wulffraat, NM, Schmitz, N & Gratwohl, A 1999, 'Autologous haematopoietic stem cell transplants for autoimmune disease - Feasibility and transplant-related mortality', Bone Marrow Transplantation, vol. 24, no. 7, pp. 729-734.
Tyndall A, Fassas A, Passweg J, Ruiz De Elvira C, Attal M, Brooks P et al. Autologous haematopoietic stem cell transplants for autoimmune disease - Feasibility and transplant-related mortality. Bone Marrow Transplantation. 1999;24(7):729-734.
Tyndall, A. ; Fassas, A. ; Passweg, J. ; Ruiz De Elvira, C. ; Attal, M. ; Brooks, P. ; Black, C. ; Durez, P. ; Finke, J. ; Forman, S. ; Fouillard, L. ; Furst, D. ; Holmes, J. A. ; Joske, D. ; Jouet, J. P. ; Kötter, I. ; Locatelli, F. ; Prentice, H. G. ; Marmont, A. M. ; McSweeney, P. ; Musso, M. ; Peter, H. H. ; Snowden, J. A. ; Sullivan, K. ; Tichelli, A. ; Vavriec, J. ; Wulffraat, N. M. ; Schmitz, N. ; Gratwohl, A. / Autologous haematopoietic stem cell transplants for autoimmune disease - Feasibility and transplant-related mortality. In: Bone Marrow Transplantation. 1999 ; Vol. 24, No. 7. pp. 729-734.
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AU - Tyndall, A.

AU - Fassas, A.

AU - Passweg, J.

AU - Ruiz De Elvira, C.

AU - Attal, M.

AU - Brooks, P.

AU - Black, C.

AU - Durez, P.

AU - Finke, J.

AU - Forman, S.

AU - Fouillard, L.

AU - Furst, D.

AU - Holmes, J. A.

AU - Joske, D.

AU - Jouet, J. P.

AU - Kötter, I.

AU - Locatelli, F.

AU - Prentice, H. G.

AU - Marmont, A. M.

AU - McSweeney, P.

AU - Musso, M.

AU - Peter, H. H.

AU - Snowden, J. A.

AU - Sullivan, K.

AU - Tichelli, A.

AU - Vavriec, J.

AU - Wulffraat, N. M.

AU - Schmitz, N.

AU - Gratwohl, A.

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