Patients with systemic sclerosis and low CD4 numbers after autologous stem cell transplantation have a favorable outcome
Abstract 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...
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| Format: | Article |
| Language: | English |
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BMC
2024-03-01
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| Series: | Arthritis Research & Therapy |
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| Online Access: | https://doi.org/10.1186/s13075-024-03300-1 |
| _version_ | 1797247130155352064 |
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| author | Ann-Christin Pecher Reinhild Klein Ina Koetter Marieke Wagner Wichard Vogel Stefan Wirths Claudia Lengerke Joerg Christoph Henes |
| author_facet | Ann-Christin Pecher Reinhild Klein Ina Koetter Marieke Wagner Wichard Vogel Stefan Wirths Claudia Lengerke Joerg Christoph Henes |
| author_sort | Ann-Christin Pecher |
| collection | DOAJ |
| description | Abstract 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. |
| first_indexed | 2024-04-24T19:53:48Z |
| format | Article |
| id | doaj.art-607d4df2ca714005b7a728ad10cd4270 |
| institution | Directory Open Access Journal |
| issn | 1478-6362 |
| language | English |
| last_indexed | 2024-04-24T19:53:48Z |
| publishDate | 2024-03-01 |
| publisher | BMC |
| record_format | Article |
| series | Arthritis Research & Therapy |
| spelling | doaj.art-607d4df2ca714005b7a728ad10cd42702024-03-24T12:28:33ZengBMCArthritis Research & Therapy1478-63622024-03-012611810.1186/s13075-024-03300-1Patients with systemic sclerosis and low CD4 numbers after autologous stem cell transplantation have a favorable outcomeAnn-Christin Pecher0Reinhild Klein1Ina Koetter2Marieke Wagner3Wichard Vogel4Stefan Wirths5Claudia Lengerke6Joerg Christoph Henes7Department of Hematology, Oncology, Clinical Immunology and Rheumatology, University Hospital TuebingenDepartment of Hematology, Oncology, Clinical Immunology and Rheumatology, University Hospital TuebingenDivision of Rheumatology and Systemic Inflammatory Rheumatic Diseases, University Hospital Hamburg-Eppendorf and Clinic for Rheumatology and ImmunologyDepartment of Hematology, Oncology, Clinical Immunology and Rheumatology, University Hospital TuebingenDepartment of Hematology, Oncology, Clinical Immunology and Rheumatology, University Hospital TuebingenDepartment of Hematology, Oncology, Clinical Immunology and Rheumatology, University Hospital TuebingenDepartment of Hematology, Oncology, Clinical Immunology and Rheumatology, University Hospital TuebingenDepartment of Hematology, Oncology, Clinical Immunology and Rheumatology, University Hospital TuebingenAbstract 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.https://doi.org/10.1186/s13075-024-03300-1Systemic sclerosisAutoimmunityAutologous stem cell transplantation |
| spellingShingle | Ann-Christin Pecher Reinhild Klein Ina Koetter Marieke Wagner Wichard Vogel Stefan Wirths Claudia Lengerke Joerg Christoph Henes Patients with systemic sclerosis and low CD4 numbers after autologous stem cell transplantation have a favorable outcome Arthritis Research & Therapy Systemic sclerosis Autoimmunity Autologous stem cell transplantation |
| title | Patients with systemic sclerosis and low CD4 numbers after autologous stem cell transplantation have a favorable outcome |
| title_full | Patients with systemic sclerosis and low CD4 numbers after autologous stem cell transplantation have a favorable outcome |
| title_fullStr | Patients with systemic sclerosis and low CD4 numbers after autologous stem cell transplantation have a favorable outcome |
| title_full_unstemmed | Patients with systemic sclerosis and low CD4 numbers after autologous stem cell transplantation have a favorable outcome |
| title_short | Patients with systemic sclerosis and low CD4 numbers after autologous stem cell transplantation have a favorable outcome |
| title_sort | patients with systemic sclerosis and low cd4 numbers after autologous stem cell transplantation have a favorable outcome |
| topic | Systemic sclerosis Autoimmunity Autologous stem cell transplantation |
| url | https://doi.org/10.1186/s13075-024-03300-1 |
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