3 years ago

Efficacy and safety of autologous haematopoietic stem cell transplantation in systemic sclerosis: A systematic review of literature

A. Eyraud, L. Scouppe, J. Seneschal, C. Richez, P. Duffau, E. Lazaro, E. Forcade, , M.-E. Truchetet, T. Barnetche
We aimed at assessing the efficacy of autologous haematopoietic stem cell transplantation (HSCT) for skin sclerosis and lung function in systemic sclerosis (SSc). We performed a systematic literature review in the Pubmed and Scopus databases from the earliest records to March 2016. We assessed quality using the Cochrane tool for randomized studies, Newcastle-Ottawa scale for controlled-cohort studies and an 18-item quality appraisal checklist for case series. The primary outcome was the improvement of skin thickening using the modified Rodnan Skin Score (mRSS). The secondary outcome was efficacy on lung function (using diffusing capacity of the lung for carbon monoxide (DLCO) and forced vital capacity (FVC)). The procedure safety was evaluated. The literature search identified 431 citations. There were 38 studies involving a total of 344 patients who fulfilled our inclusion criteria. No meta-analysis was performed due to a high heterogeneity. There was a significant improvement in mRSS in the majority of the reports (p<0.05), and the results were sustained for up to 8 years after autologous HSCT. The randomized studies and the 4 cohort studies showed each a slight but statistically significant improvement in FVC at 1 or 2 years. The treatment-related mortality (TRM) calculated by pooling patients of 35 studies (336 patients with a follow-up up to 146 months) was 8.3% after autologous HSCT and 1% in cyclophosphamide (CYC)-treated groups. Despite heterogeneity among the studies, autologous HSCT significantly improved cutaneous fibrosis and slightly the FVC. Safety of autologous HSCT is acceptable given the severity of the disease. This article is protected by copyright. All rights reserved.

Publisher URL: http://onlinelibrary.wiley.com/resolve/doi

DOI: 10.1111/bjd.15993

You might also like
Never Miss Important Research

Researcher is an app designed by academics, for academics. Create a personalised feed in two minutes.
Choose from over 15,000 academics journals covering ten research areas then let Researcher deliver you papers tailored to your interests each day.

  • Download from Google Play
  • Download from App Store
  • Download from AppInChina

Researcher displays publicly available abstracts and doesn’t host any full article content. If the content is open access, we will direct clicks from the abstracts to the publisher website and display the PDF copy on our platform. Clicks to view the full text will be directed to the publisher website, where only users with subscriptions or access through their institution are able to view the full article.