Treatment of relapse after autologous blood stem cell transplantation for severe rheumatoid arthritis

S. Z. Pavletic, Lynell Warren Klassen, R. Pope, James Robert O'Dell, A. E. Traynor, C. E. Haire, F. Graziano, F. Schuening, Y. Oyama, W. Barr, R. K. Burt

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Abstract

There is little information about the clinical course of patients with rheumatoid arthritis (RA) who relapse after autologous blood stem cell transplantation (ASCT). We describe 6 patients with severe RA who received ASCT in 3 US centers. Duration of followup was between 24 and 42 months posttransplant. Five patients achieved major responses but relapsed 3-22 months posttransplant. Two patients with relapse improved remarkably after restarting disease modifying antirheumatic drugs (DMARD). Two patients developed a mild RA flare at 3 and 5 months posttransplant and improved spontaneously. All 4 patients who improved after an initial disease flare remained highly functional at 14-22 months posttransplant. All patients in this study were anti-tumor necrosis factor (TNF) drug naive; all received a TNF blocker as a second line posttransplant salvage therapy, but only 3 responded. Future ASCT strategies need to focus on improving the durability of the early posttransplant responses.

Original languageEnglish (US)
Pages (from-to)28-31
Number of pages4
JournalJournal of Rheumatology
Volume28
Issue numberSUPPL. 64
StatePublished - Jan 1 2001

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Stem Cell Transplantation
Blood Cells
Rheumatoid Arthritis
Recurrence
Therapeutics
Tumor Necrosis Factor-alpha
Salvage Therapy
Antirheumatic Agents
Pharmaceutical Preparations

Keywords

  • Hematopoietic stem cell transplantation
  • Longterm followup
  • Relapse
  • Rheumatoid arthritis

ASJC Scopus subject areas

  • Rheumatology
  • Immunology and Allergy
  • Immunology

Cite this

Pavletic, S. Z., Klassen, L. W., Pope, R., O'Dell, J. R., Traynor, A. E., Haire, C. E., ... Burt, R. K. (2001). Treatment of relapse after autologous blood stem cell transplantation for severe rheumatoid arthritis. Journal of Rheumatology, 28(SUPPL. 64), 28-31.

Treatment of relapse after autologous blood stem cell transplantation for severe rheumatoid arthritis. / Pavletic, S. Z.; Klassen, Lynell Warren; Pope, R.; O'Dell, James Robert; Traynor, A. E.; Haire, C. E.; Graziano, F.; Schuening, F.; Oyama, Y.; Barr, W.; Burt, R. K.

In: Journal of Rheumatology, Vol. 28, No. SUPPL. 64, 01.01.2001, p. 28-31.

Research output: Contribution to journalArticle

Pavletic, SZ, Klassen, LW, Pope, R, O'Dell, JR, Traynor, AE, Haire, CE, Graziano, F, Schuening, F, Oyama, Y, Barr, W & Burt, RK 2001, 'Treatment of relapse after autologous blood stem cell transplantation for severe rheumatoid arthritis', Journal of Rheumatology, vol. 28, no. SUPPL. 64, pp. 28-31.
Pavletic, S. Z. ; Klassen, Lynell Warren ; Pope, R. ; O'Dell, James Robert ; Traynor, A. E. ; Haire, C. E. ; Graziano, F. ; Schuening, F. ; Oyama, Y. ; Barr, W. ; Burt, R. K. / Treatment of relapse after autologous blood stem cell transplantation for severe rheumatoid arthritis. In: Journal of Rheumatology. 2001 ; Vol. 28, No. SUPPL. 64. pp. 28-31.
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