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Transplantation for autoimmune diseases in north and South America: a report of the Center for International Blood and Marrow Transplant Research.

Publication ,  Journal Article
Pasquini, MC; Voltarelli, J; Atkins, HL; Hamerschlak, N; Zhong, X; Ahn, KW; Sullivan, KM; Carrum, G; Andrey, J; Bredeson, CN; Cairo, M ...
Published in: Biol Blood Marrow Transplant
October 2012

Hematopoietic cell transplantation (HCT) is an emerging therapy for patients with severe autoimmune diseases (AID). We report data on 368 patients with AID who underwent HCT in 64 North and South American transplantation centers reported to the Center for International Blood and Marrow Transplant Research between 1996 and 2009. Most of the HCTs involved autologous grafts (n = 339); allogeneic HCT (n = 29) was done mostly in children. The most common indications for HCT were multiple sclerosis, systemic sclerosis, and systemic lupus erythematosus. The median age at transplantation was 38 years for autologous HCT and 25 years for allogeneic HCT. The corresponding times from diagnosis to HCT were 35 months and 24 months. Three-year overall survival after autologous HCT was 86% (95% confidence interval [CI], 81%-91%). Median follow-up of survivors was 31 months (range, 1-144 months). The most common causes of death were AID progression, infections, and organ failure. On multivariate analysis, the risk of death was higher in patients at centers that performed fewer than 5 autologous HCTs (relative risk, 3.5; 95% CI, 1.1-11.1; P = .03) and those that performed 5 to 15 autologous HCTs for AID during the study period (relative risk, 4.2; 95% CI, 1.5-11.7; P = .006) compared with patients at centers that performed more than 15 autologous HCTs for AID during the study period. AID is an emerging indication for HCT in the region. Collaboration of hematologists and other disease specialists with an outcomes database is important to promote optimal patient selection, analysis of the impact of prognostic variables and long-term outcomes, and development of clinical trials.

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Published In

Biol Blood Marrow Transplant

DOI

EISSN

1523-6536

Publication Date

October 2012

Volume

18

Issue

10

Start / End Page

1471 / 1478

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Transplantation, Homologous
  • Transplantation, Autologous
  • South America
  • Prognosis
  • North America
  • Middle Aged
  • Male
  • Longitudinal Studies
  • Immunology
 

Citation

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ICMJE
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Pasquini, M. C., Voltarelli, J., Atkins, H. L., Hamerschlak, N., Zhong, X., Ahn, K. W., … Nash, R. A. (2012). Transplantation for autoimmune diseases in north and South America: a report of the Center for International Blood and Marrow Transplant Research. Biol Blood Marrow Transplant, 18(10), 1471–1478. https://doi.org/10.1016/j.bbmt.2012.06.003
Pasquini, Marcelo C., Julio Voltarelli, Harold L. Atkins, Nelson Hamerschlak, Xiaobo Zhong, Kwang Woo Ahn, Keith M. Sullivan, et al. “Transplantation for autoimmune diseases in north and South America: a report of the Center for International Blood and Marrow Transplant Research.Biol Blood Marrow Transplant 18, no. 10 (October 2012): 1471–78. https://doi.org/10.1016/j.bbmt.2012.06.003.
Pasquini MC, Voltarelli J, Atkins HL, Hamerschlak N, Zhong X, Ahn KW, et al. Transplantation for autoimmune diseases in north and South America: a report of the Center for International Blood and Marrow Transplant Research. Biol Blood Marrow Transplant. 2012 Oct;18(10):1471–8.
Pasquini, Marcelo C., et al. “Transplantation for autoimmune diseases in north and South America: a report of the Center for International Blood and Marrow Transplant Research.Biol Blood Marrow Transplant, vol. 18, no. 10, Oct. 2012, pp. 1471–78. Pubmed, doi:10.1016/j.bbmt.2012.06.003.
Pasquini MC, Voltarelli J, Atkins HL, Hamerschlak N, Zhong X, Ahn KW, Sullivan KM, Carrum G, Andrey J, Bredeson CN, Cairo M, Gale RP, Hahn T, Storek J, Horowitz MM, McSweeney PA, Griffith LM, Muraro PA, Pavletic SZ, Nash RA. Transplantation for autoimmune diseases in north and South America: a report of the Center for International Blood and Marrow Transplant Research. Biol Blood Marrow Transplant. 2012 Oct;18(10):1471–1478.
Journal cover image

Published In

Biol Blood Marrow Transplant

DOI

EISSN

1523-6536

Publication Date

October 2012

Volume

18

Issue

10

Start / End Page

1471 / 1478

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Transplantation, Homologous
  • Transplantation, Autologous
  • South America
  • Prognosis
  • North America
  • Middle Aged
  • Male
  • Longitudinal Studies
  • Immunology