Tyndall A, Gratwohl A
Department of Rheumatology, University of Basel, Basel, Switzerland.
Arthritis Res. 2000;2(4):276-80. doi: 10.1186/ar102. Epub 2000 May 26.
In the past 5 years, around 350 patients have received haematopoietic stem cell (HSC) transplantation for an autoimmune disease, with 275 of these registered in an international data base in Basel under the auspices of the European League Against Rheumatism (EULAR) and the European Group for Blood and Marrow Transplantation(EBMT). Most patients had either a progressive form of multiple sclerosis (MS; n = 88) or scleroderma (now called systemic sclerosis; n = 55). Other diseases were rheumatoid arthritis (Ra n = 40), juvenile idiopathic arthritis (JIA; n = 30), systemic lupus erythematosus (SLE; n = 20), idiopathic thrombocytopenic purpura (ITP; n = 7) and others. The procedure-related mortality was around 9%, with between-disease differences, being higher in systemic sclerosis and JIA and lower in RA (one death only). Benefit has been seen in around two-thirds of cases. No one regimen was clearly superior to another, with a trend toward more infectious complications with more intense regimens. Prospective, controlled randomized trials are indicated and being planned.
在过去5年中，约350名患者因自身免疫性疾病接受了造血干细胞（HSC）移植，其中275例在欧洲抗风湿病联盟（EULAR）和欧洲血液与骨髓移植组（EBMT）支持下登记在巴塞尔的一个国际数据库中。大多数患者患有进展型多发性硬化症（MS；n = 88）或硬皮病（现称系统性硬化症；n = 55）。其他疾病包括类风湿性关节炎（RA；n = 40）、幼年特发性关节炎（JIA；n = 30）、系统性红斑狼疮（SLE；n = 20）、特发性血小板减少性紫癜（ITP；n = 7）等。与手术相关的死亡率约为9%，因疾病而异，在系统性硬化症和JIA中较高，在RA中较低（仅1例死亡）。约三分之二的病例显示出益处。没有一种方案明显优于另一种方案，强化方案的感染并发症有增加趋势。需要并正在计划进行前瞻性对照随机试验。
