OP021 Autologous haematopoietic stem cell transplantation for Crohn’s disease: a retrospective study from the European Society for Blood &amp; Marrow Transplantation (EBMT) Autoimmune Diseases Working Party

Brierley, Charlotte; Castilla-Llorente, C; Labopin, Myriam; Badoglio, Manuela; Rovira, Montserrat; Ricart, Elena; Dierickx, Daan; Vermeire, Séverine; Hasselblatt, Peter; Finke, Jürgen; Onida, Francesco; Cassinotti, A.; Satsangi, Jack; Kazmi, Majid; López-Sanromán, Antonio; Farge, Dominique; Travis, Simon; Hawkey, Chris J.; Snowden, John A.

doi:10.1093/ecco-jcc/jjx180.020

Cited by 20 publications

(11 citation statements)

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“…As disease flares have been reported during G-CSF treatment in patients with multiple sclerosis, rheumatoid arthritis, and systemic lupus erythematosus [ 34 , 35 , 36 ], cyclophosphamide with a dose of 2–4 g/m 2 is applied before G-CSF treatment with 5–10 µg/kg [ 27 , 35 ]. This regime was also used in the reported trials of autologous HSCT for CD [ 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 ]. To avoid combined immunosuppression, immunomodulators and biologics for the treatment of CD should be discontinued as early as possible before cyclophosphamide application to reduce the risk of infections and to prevent interference with PBSC mobilization.…”

Section: Hsct For Crohn’s Diseasementioning

confidence: 99%

Hematopoietic Stem Cell Transplantation in Refractory Crohn’s Disease: Should It Be Considered?

Reider

Binder

Fürst

et al. 2022

Cells

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Hematopoietic stem cell transplantation (HSCT) is widely used in benign and malignant hematological diseases. During the last decade, HSCT, mainly autologous, also gained increasing attention in the treatment of refractory autoimmune diseases. Crohn’s disease (CD) is an inflammatory bowel disease leading to transmural inflammation potentially affecting all parts of the luminal gastrointestinal tract. Despite improving therapeutic options, including various biologics, some patients are refractory to all lines of available conservative therapy, leading to increased morbidity and reduced quality of life. Apart from surgery, HSCT might be a reasonable treatment alternative for refractory CD patients. This review aims to describe the current role of HSCT in CD and discusses the procedure, the correct patient selection, the clinical efficacy from initial remission to following relapse rates, and complications of this treatment.

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Section: Hsct For Crohn’s Diseasementioning

confidence: 99%

Hematopoietic Stem Cell Transplantation in Refractory Crohn’s Disease: Should It Be Considered?

Reider

Binder

Fürst

et al. 2022

Cells

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“…In relation to CD, there have been only a small number of cases where CD34 + selection has been used, and these are insufficient for meaningful analysis in the EBMT dataset. 76 In the absence of evidence of benefit, the recommendation is that CD34 + selection or other graft manipulation is not used outside a clinical trial setting.…”

Section: The Question Of Graft Manipulation In Autologous Hsctmentioning

confidence: 99%

“…Several of these questions will be answered by projects that are currently ongoing, including analysis of the long-term follow up of patients undergoing AHSCT as part of the ASTIC trial as well as an analysis of all patients who have undergone AHSCT for CD registered on the EBMT database. 76 Analysis of the mucosal T cell repertoire and disease activity before and after AHSCT will investigate the mechanisms of disease remission and relapse. 87 However, further clinical trials are required to give clear answers as to the benefit and risks of AHSCT using a low-intensity mobilization and conditioning regimen [as in the new ASTIC-lite trial].…”

Section: Clinical Trials and Other Research Questionsmentioning

confidence: 99%

Autologous Haematopoietic Stem Cell Transplantation (AHSCT) in Severe Crohn’s Disease: A Review on Behalf of ECCO and EBMT

Snowden

Panés

Alexander

et al. 2018

Journal of Crohn's and Colitis

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Despite the major recent progress in the treatment of Crohn's disease [CD], there is a subset of patients in whom the disease runs an aggressive course with progressive tissue damage requiring early and repeated surgical management. Increasing evidence supports sustained and profound improvement in gastrointestinal parameters and quality of life following high-dose immunosuppressive therapy and autologous haematopoietic stem cell transplantation [AHSCT] compared to standard therapy in this context. In addition, international transplant registry data reflect the use of AHSCT in CD outside of trials in selected patients. However, AHSCT may be associated with significant treatment-related complications with risk of transplant-related mortality. In a joint initiative, the European Crohn's and Colitis Organisation [ECCO] and the European Society for Blood and Marrow Transplantation [EBMT] have produced a state-of-the-art review of the rationale, evaluation, patient selection, stem cell mobilization and transplant procedures and long-term follow up. Given the unique spectrum of issues, we recommend that AHSCT should only be performed in experienced centres with expertise in both haematological and gastroenterological aspects of the procedure. Where possible, patients should be enrolled on clinical trials and data registered centrally. Future development should be coordinated at both national and international levels.

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“…6,7 Similar developments happened worldwide and there have been a large number of retrospective and prospective studies in a wide range of ADs. [8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27] More recently, randomized controlled trials have reported confirming proof of principle in several ADs. [28][29][30][31][32] Despite international guidelines and recommendations, the uptake of HSCT in AD has been highly variable, both geographically and in respect to type of AD.…”

Section: Introductionmentioning

confidence: 99%

Evolution, trends, outcomes, and economics of hematopoietic stem cell transplantation in severe autoimmune diseases

et al. 2017

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OP021 Autologous haematopoietic stem cell transplantation for Crohn’s disease: a retrospective study from the European Society for Blood & Marrow Transplantation (EBMT) Autoimmune Diseases Working Party

Cited by 20 publications

References 0 publications

Hematopoietic Stem Cell Transplantation in Refractory Crohn’s Disease: Should It Be Considered?

Hematopoietic Stem Cell Transplantation in Refractory Crohn’s Disease: Should It Be Considered?

Autologous Haematopoietic Stem Cell Transplantation (AHSCT) in Severe Crohn’s Disease: A Review on Behalf of ECCO and EBMT

Evolution, trends, outcomes, and economics of hematopoietic stem cell transplantation in severe autoimmune diseases

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