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Secondary autoimmune diseases occurring after HSCT for an autoimmune disease: a retrospective study of the EBMT Autoimmune Disease Working Party

Author

  • Thomas Daikeler
  • Myriam Labopin
  • Massimo Di Gioia
  • Mario Abinun
  • Tobias Alexander
  • Irene Miniati
  • Francesca Gualandi
  • Athanasios Fassas
  • Thierry Martin
  • Carl Philipp Schwarze
  • Nico Wulffraat
  • Maya Buch
  • Antonia Sampol
  • Enric Carreras
  • Benedicte Dubois
  • Bernd Gruhn
  • Tayfun Guengoer
  • David Pohlreich
  • Annemie Schuerwegh
  • Emilian Snarski
  • John Snowden
  • Paul Veys
  • Anders Fasth
  • Stig Lenhoff
  • Chiara Messina
  • Jan Voswinkel
  • Manuela Badoglio
  • Joerg Henes
  • David Launay
  • Alan Tyndall
  • Eliane Gluckman
  • Dominique Farge

Summary, in English

To specify the incidence and risk factors for secondary autoimmune diseases (ADs) after HSCT for a primary AD, we retrospectively analyzed AD patients treated by HSCT reported to EBMT from 1995 to 2009 with at least 1 secondary AD (cases) and those without (controls). After autologous HSCT, 29 of 347 patients developed at least 1 secondary AD within 21.9 (0.6-49) months and after allogeneic HSCT, 3 of 16 patients. The observed secondary ADs included: autoimmune hemolytic anemia (n = 3), acquired hemo- philia (n = 3), autoimmune thrombocytopenia (n = 3), antiphospholipid syndrome (n = 2), thyroiditis (n = 12), blocking thyroid-stimulating hormone receptor antibody (n = 1), Graves disease (n = 2), myasthenia gravis (n = 1), rheumatoid arthritis (n = 2), sarcoidosis (n = 2), vasculitis (n = 1), psoriasis (n = 1), and psoriatic arthritis (n = 1). After autologous HSCT for primary AD, the cumulative incidence of secondary AD was 9.8% +/- 2% at 5 years. Lupus erythematosus as primary AD, and antithymocyte globulin use plus CD34(+) graft selection were important risk factors for secondary AD by multivariate analysis. With a median follow-up of 6.2 (0.54-11) years after autologous HSCT, 26 of 29 patients with secondary AD were alive, 2 died during their secondary AD (antiphospholipid syndrome, hemophilia), and 1 death was HSCT-related. This European multicenter study underlines the need for careful management and follow-up for secondary AD after HSCT. (Blood. 2011;118(6):1693-1698)

Publishing year

2011

Language

English

Pages

1693-1698

Publication/Series

Blood

Volume

118

Issue

6

Document type

Journal article

Publisher

American Society of Hematology

Topic

  • Hematology

Status

Published

ISBN/ISSN/Other

  • ISSN: 1528-0020