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Blood, 15 March 2007, Vol. 109, No. 6, pp. 2643-2548. Prepublished online as a Blood First Edition Paper on November 21, 2006; DOI 10.1182/blood-2006-07-035766. This Article Full Text (PDF) All Versions of this Article: blood-2006-07-035766v1 109/6/2643    most recent Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Rights and Permissions Citing Articles Citing Articles via HighWire Citing Articles via CrossRef Citing Articles via Google Scholar Google Scholar Articles by Loh, Y. Articles by Burt, R. K Search for Related Content PubMed PubMed Citation Articles by Loh, Y. Articles by Burt, R. K Social Bookmarking                   What's this?  Previous Article  |  Next Article  Submitted July 19, 2006 Accepted November 6, 2006 Development of a secondary autoimmune disorder after hematopoietic stem cell transplantation for autoimmune diseases: role of conditioning regimen used? Yvonne Loh, Yu Oyama, Laisvyde Statkute, Kathleen Quigley, Kimberly Yaung, Elizabeth Gonda, Walter Barr, Borko Jovanovic, Robert Craig, Dusan Stefoski, Bruce Cohen, and Richard K Burt* Division of Immunotherapy, Northwestern University Feinberg Medical Center, Chicago, IL Division of Rheumatology, Northwestern University Feinberg Medical Center, Chicago, IL Dept of Preventative Medicine, Northwestern University Feinberg Medical Center, Chicago, IL Division of Gastroenterology, Northwestern University Feinberg Medical Center, Chicago, IL Dept of Neurological Sciences, Rush University Medical Center, Chicago, IL Dept of Neurology, Northwestern University Feinberg Medical Center, Chicago, IL * Corresponding author; email: rburt{at}northwestern.edu. Patients undergoing autologous HSCT (auto-HSCT) for autoimmune disease may have an added propensity to develop a second autoimmune disorder, given the genetic predisposition to autoimmunity. Therefore, we undertook a retrospective analysis of all patients who have undergone auto-HSCT for an autoimmune disease in our institution to determine the occurrence of a second autoimmune disorder and possible risk factors. In all, 155 patients underwent auto-HSCT for various autoimmune diseases, of which 6 manifested a distinct secondary autoimmune disease at a median of 8.5 months (2 to 30 months) after auto-HSCT. Two patients with systemic lupus erythematosus, conditioned with a regimen containing antithymocyte globulin (ATG), developed factor VIII inhibitors with severe bleeding. Four patients (2 with multiple sclerosis, one each with lupus and systemic sclerosis) who received an alemtuzumab-containing conditioning regimen developed autoimmune cytopenias. Among the 155 patients, the frequency of secondary autoimmune complications was 16.0% with alemtuzumab (4/25), 1.9% for ATG (2/102) and 0% for conditioning regimens without lympho-depleting antibodies (0/28)-a difference which was found to be significantly higher with alemtuzumab exposure (p=0.011). In contrast, gender, type of ATG utilized, and CD34-selection of peripheral blood stem cells were not found to be significantly associated with development of a secondary autoimmune disorder. CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this? This article has been cited by other articles: T. BOHGAKI, T. ATSUMI, M. BOHGAKI, A. FURUSAKI, M. KONDO, K. C. SATO-MATSUMURA, R. ABE, H. KATAOKA, T. HORITA, S. YASUDA, et al. Immunological Reconstitution after Autologous Hematopoietic Stem Cell Transplantation in Patients with Systemic Sclerosis: Relationship Between Clinical Benefits and Intensity of Immunosuppression J Rheumatol, June 1, 2009; 36(6): 1240 - 1248. [Abstract] [Full Text] [PDF] The CAMMS223 Trial Investigators Alemtuzumab vs. Interferon Beta-1a in Early Multiple Sclerosis N. Engl. J. Med., October 23, 2008; 359(17): 1786 - 1801. [Abstract] [Full Text] [PDF] F. Braiteh, S. R. Hymes, S. A. Giralt, and R. Jones Complete Remission of Psoriasis After Autologous Hematopoietic Stem-Cell Transplantation for Multiple Myeloma J. Clin. Oncol., September 20, 2008; 26(27): 4511 - 4513. [Full Text] [PDF] R. K. Burt, Y. Loh, W. Pearce, N. Beohar, W. G. Barr, R. Craig, Y. Wen, J. A. Rapp, and J. Kessler Clinical Applications of Blood-Derived and Marrow-Derived Stem Cells for Nonmalignant Diseases JAMA, February 27, 2008; 299(8): 925 - 936. [Abstract] [Full Text] [PDF] R. A. Nash, P. A. McSweeney, L. J. Crofford, M. Abidi, C.-S. Chen, J. D. Godwin, T. A. Gooley, L. Holmberg, G. Henstorf, C. F. LeMaistre, et al. High-dose immunosuppressive therapy and autologous hematopoietic cell transplantation for severe systemic sclerosis: long-term follow-up of the US multicenter pilot study Blood, August 15, 2007; 110(4): 1388 - 1396. [Abstract] [Full Text] [PDF]

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