Miniati I et al. – Autologous Hemopoietic Stem Cells Transplantation (HSCT) with high dose cyclophosphamide (CYC) regimen may foster vascular remodelling while CYC at lower doses and with a chronic regimen does not influence the microvasculature. Methods
A study to evaluate the improvement of microvasculature after HSCT severe diffuse cutaneous systemic sclerosis (dcSSc) pts
16 severe dcSSc pts, with a "late" videocapillaroscopy pattern underwent an immunesuppressive treatment
6 were treated with HSCT and 10 with monthly pulse of CYC 1 g for 6 mos and then orally with 50 mg/day for further 6 mos
Nailfold videocapillaroscopy (NVC) was performed before and after 3 mos from the beginning of each treatment and then repeated every 3 mos
Results
In all pts, before HSCT, NVC large avascular areas and ramified capillaries and vascular architectural disorganization ("late" pattern) was noted
3 mos after HSCT, NVC pattern changed from "late" into "active", showing frequent giant capillaries (>6/mm) and haemorrhages, absence of avascular areas and angiogenesis phenomena
After 1 year from HSCT, microvascular abnormalities were still in the "active" pattern
In pts treated with CYC, no NVC modifications were observed during 24 mos of f/u and the pattern remained always "late”
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