scholarly journals Autologous hematopoietic stem cell transplantation in the treatment of systemic sclerosis. Part 2. Safety and complications

2021 ◽  
Vol 15 (1) ◽  
pp. 66-72
Author(s):  
O. B. Ovsyannikova ◽  
L. P. Ananyeva ◽  
O. A. Koneva ◽  
L. A. Garzanova ◽  
O. V. Desinova ◽  
...  
Keyword(s):  
Stem Cell ◽  
Systemic Sclerosis ◽  
Hematopoietic Stem Cell Transplantation ◽  
Stem Cell Transplantation ◽  
Cell Transplantation ◽  
Hematopoietic Stem Cell ◽  
Causes Of Death ◽  
Controlled Clinical Trials ◽  
Hematopoietic Stem ◽  
Positive Results

Autologous hematopoietic stem cell transplantation (auto-HSCT) is presently the only disease-modifying strategy for the treatment of systemic sclerosis (SSs) that has Level A evidence, the effectiveness of which has been proven in three controlled clinical trials: ASSIST, ASTIS, and SCOT. Despite the positive results obtained with the use of this treatment option, the issues related to its tolerability and safety remain unresolved. The complications caused by obvious immunosuppression and higher frequency of infections are the main causes of death after autoHSCT for autoimmune diseases and occur mainly in the first month after treatment. Overall, the studies performed confirm the overall assessment of auto-HSCT as an effective and relatively safe treatment for severe SSs.

scholarly journals Rituximab as a Treatment Option after Autologous Hematopoietic Stem Cell Transplantation in a Patient with Systemic Sclerosis

2021 ◽  
Vol 11 (7) ◽  
pp. 600
Author(s):  
Paul Gressenberger ◽  
Philipp Jud ◽  
Gabor Kovacs ◽  
Sonja Kreuzer ◽  
Hans-Peter Brezinsek ◽  
...  
Keyword(s):  
Stem Cell ◽  
Systemic Sclerosis ◽  
Hematopoietic Stem Cell Transplantation ◽  
Stem Cell Transplantation ◽  
Cell Transplantation ◽  
Hematopoietic Stem Cell ◽  
Treatment Option ◽  
Clinical Symptoms ◽  
Stable Condition ◽  
Hematopoietic Stem

Systemic sclerosis (SSc) is an intractable autoimmune disease characterized by vasculopathy and organ fibrosis. Autologous hematopoietic stem cell transplantation (AHSCT) should be considered for the treatment of selected patients with rapid progressive SSc at high risk of organ failure. It, however, remains elusive whether immunosuppressive therapies such as rituximab (RTX) are still necessary for such patients after AHSCT, especially in those with bad outcomes. In the present report, a 43-year-old man with diffuse cutaneous SSc received AHSCT. Despite AHSCT, SSc further progressed with progressive symptomatic heart failure with newly developed concomitant mitral and tricuspid valve insufficiency, thus the patient started on RTX 8 months after AHSCT. Shortly after initiation of RTX, clinical symptoms and organ functions ameliorated subsequently. Heart valve regurgitations were reversible after initiation of RTX treatment. Currently, the patient remains in a stable condition with significant improvement of clinical symptoms and organ functions. Reporting about therapies after AHSCT in SSc is a very important issue, as randomized controlled trials are lacking, and therefore this report adds to evidence that RTX can be considered as a treatment option in patients with SSc that do not respond to AHSCT.

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