Secondary autoimmune diseases occurring after HSCT for an autoimmune disease: A retrospective study of the EBMT Autoimmune Disease Working Party

Thomas Daikeler, Myriam Labopin, Massimo Di Gioia, Mario Abinun, Tobias Alexander, Irene Miniati, Francesca Gualandi, Athanasios Fassas, Thierry Martin, Carl Philipp Schwarze, Nico Wulffraat, Maya Buch, Antonia Sampol, Enric Carreras, Benedicte Dubois, Bernd Gruhn, Tayfun Güngör, David Pohlreich, Annemie Schuerwegh, Emilian SnarskiJohn Snowden, Paul Veys, Anders Fasth, Stig Lenhoff, Chiara Messina, Jan Voswinkel, Manuela Badoglio, Jörg Henes, David Launay, Alan Tyndall, Eliane Gluckman, Dominique Farge

Research output: Contribution to journalArticlepeer-review

Abstract

To specify the incidence and risk factors for secondary autoimmune diseases (ADs) after HSCT for a primary AD, we retrospectively analyzed AD patients treated by HSCT reported to EBMT from 1995 to 2009 with at least 1 secondary AD (cases) and those without (controls). After autologous HSCT, 29 of 347 patients developed at least 1 secondary AD within 21.9 (0.6-49) months and after allogeneic HSCT, 3 of 16 patients. The observed secondaryADs included: autoimmune hemolytic anemia (n ∇ 3), acquired hemophilia (n ∇ 3), autoimmune thrombocytopenia (n ∇ 3), antiphospholipid syndrome (n ∇ 2), thyroiditis (n ∇ 12), blocking thyroid- stimulating hormone receptor antibody (n ∇ 1), Graves disease (n ∇ 2), myasthenia gravis (n ∇ 1), rheumatoid arthritis (n ∇ 2), sarcoidosis (n ∇ 2), vasculitis (n ∇ 1), psoriasis (n ∇ 1), and psoriatic arthritis (n ∇ 1). After autologous HSCT for primary AD, the cumulative incidence of secondary AD was 9.8% ±2% at 5 years. Lupus erythematosus as primary AD, and antithymocyte globulin use plus CD34+ graft selection were important risk factors for secondary AD by multivariate analysis. With a median follow-up of 6.2 (0.54-11) years after autologous HSCT, 26 of 29 patients with secondary AD were alive, 2 died during their secondary AD (antiphospholipid syndrome, hemophilia), and 1 death was HSCT-related. This European multicenter study underlines the need for careful management and follow-up for secondary AD after HSCT.

Original languageEnglish
Pages (from-to)1693-1698
Number of pages6
JournalBlood
Volume118
Issue number6
DOIs
Publication statusPublished - Aug 11 2011

ASJC Scopus subject areas

  • Hematology
  • Biochemistry
  • Cell Biology
  • Immunology

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