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Immunological reconstitution after autologous hematopoietic stem cell transplantation in patients with systemic sclerosis: Relationship between clinical benefits and intensity of immunosuppression
Journal of Rheumatology, 06/15/09

Bohgaki T et al. – Data suggest that immunosuppression intensity, sufficient to induce transient suppression of thymic function, is attributable to the feasible clinical response in patients with systemic sclerosis (SSc) treated with autologous hematopoietic stem cell transplantation (HSCT).

• An analysis of the relationship between clinical benefits and immunological changes in SSc pts treated with autologous HSCT
• 10 pts were treated with high-dose cyclophosphamide followed by highly purified CD34+ cells (n=5) or unpurified grafts (n=5)
• 2 groups of pts were retrospectively constituted based on their clinical response (good and poor)
• Clinical findings, immunological reconstitution through autologous HSCT was assessed by FACS analysis, quantification of sjTREC, reflecting the thymic function, and foxp3 mRNA levels

• Pts’ clinical and immunological findings were similar between good and poor responders, or CD34-purified and unpurified groups at inclusion
• The sjTREC values were suppressed at 3 mo after autologous HSCT in good responders vs poor responders
• Reconstitution of CD4+CD45RO- naive T cells was delayed in good responders vs poor responders
• The phenotype of other lymphocytes, cytokine production in T cells, and foxp3 gene expression levels after HSCT did not correlate with clinical response in good or poor responders
• Clinical and immunological findings after autologous HSCT were similar between CD34-purified and unpurified groups

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