2014
DOI: 10.1038/bmt.2014.251
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SCT for severe autoimmune diseases: consensus guidelines of the European Society for Blood and Marrow Transplantation for immune monitoring and biobanking

Abstract: Over the past 15 years, SCT has emerged as a promising treatment option for patients with severe autoimmune diseases (ADs). Mechanistic studies recently provided the proof-of-concept that restoration of immunological tolerance can be achieved by haematopoietic SCT in chronic autoimmunity through eradication of the pathologic, immunologic memory and profound reconfiguration of the immune system, that is, immune ‘resetting'. Nevertheless, a number of areas remain unresolved and warrant further investigation to r… Show more

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Cited by 81 publications
(60 citation statements)
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“…25 Recent publications on post-transplantation immune monitoring in AD have shown that it is more important to promote a balance between tolerance and autoreactivity than to completely ablate the original immune system. 12,26,27 This is achieved via an increase in the number and function of regulatory cells, with thymic reactivation, emergence of a polyclonal TCR repertoire and normalization of epigenetic abnormalities among other immunological effects. 27,28 Therefore, the potential reinfusion of autoreactive T-cells within the non-selected graft may not be clinically relevant in SSc, as other mechanisms may be operating for reset of the immunological balance and disease control after AHSCT in AD.…”
Section: Resultsmentioning
confidence: 99%
See 1 more Smart Citation
“…25 Recent publications on post-transplantation immune monitoring in AD have shown that it is more important to promote a balance between tolerance and autoreactivity than to completely ablate the original immune system. 12,26,27 This is achieved via an increase in the number and function of regulatory cells, with thymic reactivation, emergence of a polyclonal TCR repertoire and normalization of epigenetic abnormalities among other immunological effects. 27,28 Therefore, the potential reinfusion of autoreactive T-cells within the non-selected graft may not be clinically relevant in SSc, as other mechanisms may be operating for reset of the immunological balance and disease control after AHSCT in AD.…”
Section: Resultsmentioning
confidence: 99%
“…12,26,27 This is achieved via an increase in the number and function of regulatory cells, with thymic reactivation, emergence of a polyclonal TCR repertoire and normalization of epigenetic abnormalities among other immunological effects. 27,28 Therefore, the potential reinfusion of autoreactive T-cells within the non-selected graft may not be clinically relevant in SSc, as other mechanisms may be operating for reset of the immunological balance and disease control after AHSCT in AD. Further studies to explore details of CD34+ selection, such as the degree of T-cell depletion and post-transplant lymphocyte reconstitution, are still required.…”
Section: Resultsmentioning
confidence: 99%
“…15,31 Whether our data can be extrapolated to other (non)-juvenile autoimmune patients undergoing HSCT remains to be established. Recently, immune monitoring and biobanking of HSCT-treated AID patient sample guidelines have been published 32 that may make it possible to answer specific research questions that require unique patient samples.…”
Section: Discussionmentioning
confidence: 99%
“…[47][48][49][50] The recent publication of guidelines for studies of immune reconstitution studies and biobanking provides the necessary framework for further development of mechanistic studies. 51 More standardized approaches to immune monitoring should facilitate correlative studies with outcomes of HSCT and potentially enable biomarkers to be developed to assist with patient selection and treatments. 52 As well as long-term efficacy and safety there is also major health economic dynamic between HSCT and standard alternatives in the main autoimmune disease indications.…”
Section: Discussionmentioning
confidence: 99%