Patients with systemic sclerosis and low CD4 numbers after autologous stem cell transplantation have a favorable outcome

TY - JOUR

T1 - Patients with systemic sclerosis and low CD4 numbers after autologous stem cell transplantation have a favorable outcome

AU - Pecher, Ann-Christin

AU - Klein, Reinhild

AU - Koetter, Ina

AU - Wagner, Marieke

AU - Vogel, Wichard

AU - Wirths, Stefan

AU - Lengerke, Claudia

AU - Henes, Joerg Christoph

N1 - © 2024. The Author(s).

PY - 2024/3/20

Y1 - 2024/3/20

N2 - BACKGROUND: Treatment with high-dose chemotherapy followed by autologous hematopoietic stem cell transplantation (aHSCT) is an intensive treatment option for patients with severe forms of systemic sclerosis (SSc). Even though associated with a high treatment related mortality, the results in this high-risk population are generally favourable. The knowledge on the potential mechanism of action of this therapy and how it can improve patients with SSc is crucial to better select the right patients for aHSCT.METHODS: This is a monocentric retrospective study from Tübingen, Germany, including 32 patients who underwent aHSCT. Peripheral blood samples were analysed for different lymphocyte subsets at various timepoints before and after aHSCT. Patients were divided into responders and non-responders according to the modified Rodnan skin score and lung function test in the three years following aHSCT.RESULTS: Responders showed significantly lower levels of cluster of differentiation (CD)4 positive T cells in the first months after aHSCT (month 1 and 3), B cells (month 3 and 6 after aHSCT) and natural killer cells (month 1). Mantel-cox test showed a significant deviation of the probability curves, i.e. patients with lower CD4 + T cells and natural killer cells one month and B cells after 3 months after stem cell transplantation had a higher probability to belong to the responder group.CONCLUSIONS: Taken together, this study supports the theory that a profound CD4 + T cell and B cell lymphopenia is important for patients with SSc to achieve a sustained response after aHSCT.

AB - BACKGROUND: Treatment with high-dose chemotherapy followed by autologous hematopoietic stem cell transplantation (aHSCT) is an intensive treatment option for patients with severe forms of systemic sclerosis (SSc). Even though associated with a high treatment related mortality, the results in this high-risk population are generally favourable. The knowledge on the potential mechanism of action of this therapy and how it can improve patients with SSc is crucial to better select the right patients for aHSCT.METHODS: This is a monocentric retrospective study from Tübingen, Germany, including 32 patients who underwent aHSCT. Peripheral blood samples were analysed for different lymphocyte subsets at various timepoints before and after aHSCT. Patients were divided into responders and non-responders according to the modified Rodnan skin score and lung function test in the three years following aHSCT.RESULTS: Responders showed significantly lower levels of cluster of differentiation (CD)4 positive T cells in the first months after aHSCT (month 1 and 3), B cells (month 3 and 6 after aHSCT) and natural killer cells (month 1). Mantel-cox test showed a significant deviation of the probability curves, i.e. patients with lower CD4 + T cells and natural killer cells one month and B cells after 3 months after stem cell transplantation had a higher probability to belong to the responder group.CONCLUSIONS: Taken together, this study supports the theory that a profound CD4 + T cell and B cell lymphopenia is important for patients with SSc to achieve a sustained response after aHSCT.

KW - Humans

KW - Hematopoietic Stem Cell Transplantation/methods

KW - Retrospective Studies

KW - Transplantation, Autologous/methods

KW - Scleroderma, Systemic

KW - Stem Cell Transplantation

U2 - 10.1186/s13075-024-03300-1

DO - 10.1186/s13075-024-03300-1

M3 - SCORING: Journal article

C2 - 38509633

VL - 26

SP - 75

JO - ARTHRITIS RES THER

JF - ARTHRITIS RES THER

SN - 1478-6354

IS - 1

ER -