Secondary autoimmune diseases occurring after HSCT for an autoimmune disease: a retrospective study of the EBMT Autoimmune Disease Working Party.
Thomas Daikeler
(1)
,
Myriam Labopin
(2)
,
Massimo Di Gioia
(3)
,
Mario Abinun
(4)
,
Tobias Alexander
(5)
,
Irene Miniati
(6)
,
Francesca Gualandi
(7)
,
Athanasios Fassas
(8)
,
Thierry Martin
(9)
,
Carl Philipp Schwarze
(10)
,
Nico Wulffraat
(11)
,
Maya Buch
(12)
,
Antonia Sampol
(13)
,
Enric Carreras
(14)
,
Benedicte Dubois
(15)
,
Bernd Gruhn
(16)
,
Tayfun Güngör
(17)
,
David Pohlreich
(18)
,
Annemie Schuerwegh
(19)
,
Emilian Snarski
(20)
,
John Snowden
(21)
,
Paul Veys
(22)
,
Anders Fasth
(23)
,
Stig Lenhoff
(24)
,
Chiara Messina
(25)
,
Jan Voswinkel
(2)
,
Manuela Badoglio
(26)
,
Jörg Henes
(27)
,
David Launay
(28)
,
Alan Tyndall
(1)
,
Eliane Gluckman
(29)
,
Dominique Farge
(30)
1
Department of Rheumatology
2 CHU Saint-Antoine [AP-HP]
3 Haematology Department
4 Newcastle General Hospital
5 Department of Rheumatology & Clinical Immunology
6 Department of Biomedicine
7 Department of Haematology II
8 Neurology & Haematology
9 ICT - Immunologie et chimie thérapeutiques
10 Paediatric Haematology & Endocrinology
11 University Medical Center
12 Section of Musculoskeletal Disease
13 Hospital Universitari Son Espases
14 Department of Hematology
15 Department of Neurology
16 Department of Pediatrics
17 Division of Immunology/Hematology/BMT
18 Charles University Hospital
19 Department of Rheumatology
20 Department of Hematology & Oncology
21 Department of Haematology & Department of Oncology
22 GOSH - Great Ormond Street Hospital for Children [London]
23 Department of Pediatrics
24 Department of Hematology
25 Dipartimento di Pediatria
26 UMRS893 - Centre de Recherche Saint-Antoine
27 Department of Hematology & Rheumatology
28 Department of Internal Medicine
29 Clinical Research Unit
30 IDO (U976 / UMR_S 976) - Immunologie, dermatologie, oncologie ; Oncodermatologie, immunologie et cellules souches cutanées
2 CHU Saint-Antoine [AP-HP]
3 Haematology Department
4 Newcastle General Hospital
5 Department of Rheumatology & Clinical Immunology
6 Department of Biomedicine
7 Department of Haematology II
8 Neurology & Haematology
9 ICT - Immunologie et chimie thérapeutiques
10 Paediatric Haematology & Endocrinology
11 University Medical Center
12 Section of Musculoskeletal Disease
13 Hospital Universitari Son Espases
14 Department of Hematology
15 Department of Neurology
16 Department of Pediatrics
17 Division of Immunology/Hematology/BMT
18 Charles University Hospital
19 Department of Rheumatology
20 Department of Hematology & Oncology
21 Department of Haematology & Department of Oncology
22 GOSH - Great Ormond Street Hospital for Children [London]
23 Department of Pediatrics
24 Department of Hematology
25 Dipartimento di Pediatria
26 UMRS893 - Centre de Recherche Saint-Antoine
27 Department of Hematology & Rheumatology
28 Department of Internal Medicine
29 Clinical Research Unit
30 IDO (U976 / UMR_S 976) - Immunologie, dermatologie, oncologie ; Oncodermatologie, immunologie et cellules souches cutanées
Myriam Labopin
- Fonction : Auteur
- PersonId : 761953
- ORCID : 0000-0003-4514-4748
Thierry Martin
- Fonction : Auteur
- PersonId : 1647
- IdHAL : thierry-martin
- IdRef : 170408108
Maya Buch
- Fonction : Auteur
- PersonId : 764914
- ORCID : 0000-0002-8962-5642
David Launay
- Fonction : Auteur
- PersonId : 760551
- ORCID : 0000-0003-1840-1817
- IdRef : 073349364
Résumé
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 hemophilia (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.