Hernanz Nerea, Sierra María, Volpato Nadja, Núñez-Gómez Laura, Mesonero Francisco, Herrera-Puente Pilar, García-Gutiérrez Valentín, Albillos Agustín, López-San Román Antonio
Servicio de Gastroenterología y Hepatología, Hospital Universitario Ramón y Cajal, Madrid, España.
Servicio de Hematología, Hospital Universitario Ramón y Cajal, Madrid, España.
Gastroenterol Hepatol. 2019 Jan;42(1):16-22. doi: 10.1016/j.gastrohep.2018.08.004. Epub 2018 Oct 15.
Autologous haematopoietic stem cell transplantation (AHSCT) is an accepted treatment in refractory Crohn's disease (CD).
Data on patients with refractory CD subjected to AHSCT are collected at the Hospital Universitario Ramón y Cajal in Madrid and the results obtained are described retrospectively.
Seven patients in total have received AHSCT due to refractory CD in our centre. Three patients (43%) presented with clinical and endoscopic remission; one patient (14%) clinical improvement without remission and three patients (43%) remained active with the need to restart treatment in the assessment of the initial response to the AHSCT (after six months). Symptoms recurred in five of the seven patients (71%) and all of them had to restart medical treatment after an average of 13.8 months (range: 3-30 months). Only one patient needed surgery after the AHSCT. At the end of the follow-up, after a mean of 48 months (range: 17-78 months), 5/7 (71%) of the patients were in clinical remission with or without treatment.
AHSCT may be a promising therapeutic option for patients with refractory CD. Its usefulness lies in the fact that it can produce clinical remission without treatment in some patients, but also that it can make the disease treatable, obtaining a response to certain treatments in patients who had previously lost it.
自体造血干细胞移植(AHSCT)是难治性克罗恩病(CD)公认的一种治疗方法。
收集马德里拉蒙·卡哈尔大学医院接受AHSCT治疗的难治性CD患者的数据,并对所获结果进行回顾性描述。
在我们中心,共有7例因难治性CD接受了AHSCT。3例患者(43%)实现了临床和内镜缓解;1例患者(14%)临床症状改善但未缓解,3例患者(43%)病情仍活跃,在评估AHSCT的初始反应(6个月后)时需要重新开始治疗。7例患者中有5例(71%)症状复发,他们均在平均13.8个月(范围:3 - 30个月)后不得不重新开始药物治疗。AHSCT后只有1例患者需要手术。随访结束时,平均随访48个月(范围:17 - 78个月),7例患者中有5例(71%)无论是否接受治疗均处于临床缓解状态。
AHSCT对于难治性CD患者可能是一种有前景的治疗选择。它的效用在于,它可以使一些患者在未接受治疗的情况下实现临床缓解,还在于它可以使疾病变得可治,让先前对某些治疗失去反应的患者获得反应。