Hematopoietic stem cell transplantation for autoimmune diseases in the time of COVID-19: EBMT guidelines and recommendations DOI Creative Commons
Raffaella Greco, Tobias Alexander, Joachim Burman

et al.

Bone Marrow Transplantation, Journal Year: 2021, Volume and Issue: 56(7), P. 1493 - 1508

Published: May 24, 2021

Coronavirus disease-19 (COVID-19), caused by Severe Acute Respiratory Syndrome 2 (SARS-CoV-2), represents one of the biggest challenges 21st century, threatening public health around globe. Increasing age and presence co-morbidities are reported risk factors for severe disease mortality, along with autoimmune diseases (ADs) immunosuppressive treatments such as haematopoietic stem cell transplantation (HSCT), which also associated adverse outcomes. We review impact pandemic on specific groups patients neurological, rheumatological, gastroenterological indications, delivering HSCT in adult pediatric populations. Moving forward, we developed consensus-based guidelines recommendations best practice quality patient care order to support clinicians, scientists, their multidisciplinary teams, well carers. These aim national international organizations related local clinical teams HSCT. Areas unmet need future research questions highlighted. The waves COVID-19 predicted be followed an "endemic" phase therefore ongoing within a "new normality". reflect currently available evidence, coupled expert opinion, will revised according necessary modifications practice.

Language: Английский

Comparative Effectiveness of Autologous Hematopoietic Stem Cell Transplant vs Fingolimod, Natalizumab, and Ocrelizumab in Highly Active Relapsing-Remitting Multiple Sclerosis DOI
Tomáš Kalinčík, Sifat Sharmin, Izanne Roos

et al.

JAMA Neurology, Journal Year: 2023, Volume and Issue: 80(7), P. 702 - 702

Published: May 15, 2023

Autologous hematopoietic stem cell transplant (AHSCT) is available for treatment of highly active multiple sclerosis (MS).

Language: Английский

Citations

21
Haematopoietic stem cell transplantation for treatment of relapsing-remitting multiple sclerosis in Sweden: an observational cohort study DOI Creative Commons
Thomas Silfverberg, Christina Zjukovskaja, Per Ljungman

et al.

Journal of Neurology Neurosurgery & Psychiatry, Journal Year: 2023, Volume and Issue: 95(2), P. 125 - 133

Published: Sept. 25, 2023

Background A growing evidence base supports the use of autologous haematopoietic stem cell transplantation (aHSCT) for treatment relapsing-remitting multiple sclerosis (RRMS), but it has not yet been integrated into most national clinical guidelines. The objective this study was to assess efficacy and safety when aHSCT is implemented in routine healthcare. Methods We assessed 231 patients final analysis included 174 RRMS who were treated with Sweden before 1 January 2020. Efficacy evaluated by performing a retrospective prospectively collected data from Swedish MS registry. Procedure-related analysing electronic patient records covering period 100 days following aHSCT. Results With median follow-up time 5.5 (IQR: 3.4–7.5) years, Kaplan-Meier estimate no disease activity 73% (95% CI 66% 81%) at 5 years 65% 57% 75%) 10 years. Out 149 baseline disability, 80 (54%) improved, 55 (37%) stable 14 (9%) deteriorated. mean number adverse events per 1.7 (±SD: 1.5) grade 3 0.06 0.3) 4 events. Febrile neutropenia common event, affecting 68% patients. There treatment-related mortality. Conclusions Treatment associated freedom majority patients, acceptable This procedure should be considered standard care highly active RRMS.

Language: Английский

Citations

17
Effectiveness of autologous haematopoietic stem cell transplantation versus natalizumab in progressive multiple sclerosis DOI
Tomáš Kalinčík, Sifat Sharmin, Izanne Roos

et al.

Journal of Neurology Neurosurgery & Psychiatry, Journal Year: 2024, Volume and Issue: 95(8), P. 775 - 783

Published: March 27, 2024

Background Natalizumab was not shown to modify disability in progressive multiple sclerosis (MS). This matched observational study compared the effectiveness of autologous haematopoietic stem cell transplantation (AHSCT) with natalizumab MS. Methods Patients primary/secondary MS from seven AHSCT centres and MSBase registry, treated or natalizumab, were on a propensity score derived sex, age, Expanded Disability Status Scale (EDSS), number relapses 12/24 months before baseline, time onset, most effective prior therapy country. The pairwise-censored groups hazards 6-month confirmed EDSS worsening improvement, annualised relapse rates (ARRs), using Andersen-Gill proportional models conditional negative binomial model. Results 39 patients (37 secondary MS, mean age 37 years, 5.7, 28% recent progression, ARR 0.54 during preceding year) 65 natalizumab. found no evidence for difference (HR 1.49, 95% CI 0.70 3.14) improvement 1.50, 0.22 10.29) between over up 4 years. activity also similar while (ARR: mean±SD 0.08±0.28 vs 0.08±0.25; HR 1.05, 0.39 2.82). In group, 3 experienced febrile neutropenia mobilisation, 9 serum sickness, 6 required intensive care unit admission 36 complications after discharge. No treatment-related deaths reported. Conclusion does support use control advanced low activity.

Language: Английский

Citations

6
Autologous haematopoietic stem cell transplantation compared with alemtuzumab for relapsing–remitting multiple sclerosis: an observational study DOI Creative Commons

Christina Zhukovsky,

Sofia Sandgren, Thomas Silfverberg

et al.

Journal of Neurology Neurosurgery & Psychiatry, Journal Year: 2020, Volume and Issue: 92(2), P. 189 - 194

Published: Oct. 26, 2020

To compare outcomes after treatment with autologous haematopoietic stem cell transplantation (AHSCT) and alemtuzumab (ALZ) in patients relapsing-remitting multiple sclerosis.Patients treated AHSCT (n=69) received a conditioning regimen of cyclophosphamide (200 mg/kg) rabbit anti-thymocyte globulinerG (6.0 mg/kg). Patients ALZ (n=75) dose 60 mg over 5 days, repeated 36 3 days 1 year then as needed. Follow-up visits assessment the expanded disability status scale score, adverse events MR investigations were made at least yearly.The Kaplan-Meier estimates primary outcome measure 'no evidence disease activity' was 88% for 37% years, p<0.0001. The secondary endpoint annualised relapse rate 0.04 0.1 ALZ, p=0.03. At last follow-up, proportions who improved, stable or worsened 57%/41%/1% 45%/43%/12% (ALZ), p=0.06 Adverse grade three higher present 48/69 0/75 first 100 initiation. most common long-term event thyroid years 21% 46% p=0.005.In this observational cohort study, associated likelihood maintaining activity'. more frequent but thereafter ALZ.

Language: Английский

Citations

40
Hematopoietic stem cell transplantation for autoimmune diseases in the time of COVID-19: EBMT guidelines and recommendations DOI Creative Commons
Raffaella Greco, Tobias Alexander, Joachim Burman

et al.

Bone Marrow Transplantation, Journal Year: 2021, Volume and Issue: 56(7), P. 1493 - 1508

Published: May 24, 2021

Coronavirus disease-19 (COVID-19), caused by Severe Acute Respiratory Syndrome 2 (SARS-CoV-2), represents one of the biggest challenges 21st century, threatening public health around globe. Increasing age and presence co-morbidities are reported risk factors for severe disease mortality, along with autoimmune diseases (ADs) immunosuppressive treatments such as haematopoietic stem cell transplantation (HSCT), which also associated adverse outcomes. We review impact pandemic on specific groups patients neurological, rheumatological, gastroenterological indications, delivering HSCT in adult pediatric populations. Moving forward, we developed consensus-based guidelines recommendations best practice quality patient care order to support clinicians, scientists, their multidisciplinary teams, well carers. These aim national international organizations related local clinical teams HSCT. Areas unmet need future research questions highlighted. The waves COVID-19 predicted be followed an "endemic" phase therefore ongoing within a "new normality". reflect currently available evidence, coupled expert opinion, will revised according necessary modifications practice.

Language: Английский

Citations

39