Autologous stem cell transplantation: a possible treatment for refractory juvenile chronic arthritis?
| العنوان: | Autologous stem cell transplantation: a possible treatment for refractory juvenile chronic arthritis? |
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| المؤلفون: | W. Kuis, N. M. Wulffraat |
| المصدر: | Rheumatology. 38:764-766 |
| بيانات النشر: | Oxford University Press (OUP), 1999. |
| سنة النشر: | 1999 |
| مصطلحات موضوعية: | Male, medicine.medical_specialty, Transplantation Conditioning, Cyclophosphamide, T-Lymphocytes, Transplantation, Autologous, Gastroenterology, Lymphocyte Depletion, Autologous stem-cell transplantation, Rheumatology, Prednisone, Internal medicine, Cyclosporin a, Humans, Medicine, Pharmacology (medical), Preparative Regimen, medicine.diagnostic_test, business.industry, Hematopoietic Stem Cell Transplantation, Infant, Total body irradiation, medicine.disease, Arthritis, Juvenile, Surgery, Treatment Outcome, Child, Preschool, Erythrocyte sedimentation rate, Female, business, Juvenile rheumatoid arthritis, medicine.drug |
| الوصف: | Objective. In adults, autologous stem cell transplantation (ASCT) has been described recently as a possible treatment for severe autoimmune disease refractory to conventional treatment. We report here the four first children with severe forms of juvenile chronic arthritis (JCA) treated with ASCT. Methods. We studied three children with systemic JCA and one child with polyarticular JCA. Unprimed bone marrow was harvested 1 month prior to ASCT. T-cell depletion of the graft was performed with CD2 and CD3 antibodies. We used a preparative regimen of antithymocyte globulin (ATG; 20 mg/kg), cyclophosphamide (Cy; 200 mg/kg) and low-dose total body irradiation (TBI; 4 Gy). Methotrexate (MTX) and cyclosporin A (CsA) were stopped before ASCT; prednisone was tapered after 2 months. Results. After ASCT, our patients showed an anti-inflammatory-drug-free follow-up of 6-18 months with a marked decrease in joint swelling, pain and morning stiffness. The erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) and haemoglobin (Hb) returned to near-normal values within 6 weeks. Despite T-cell depletion, there was a very rapid immune reconstitution. Two patients developed a limited varicella zoster virus (VZV) eruption which was treated by acyclovir. |
| تدمد: | 1462-0332 1462-0324 |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::dd8009a2a68c2186af20cb0b647933fa https://doi.org/10.1093/rheumatology/38.8.764 |
| حقوق: | OPEN |
| رقم الأكسشن: | edsair.doi.dedup.....dd8009a2a68c2186af20cb0b647933fa |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 14620332 14620324 |
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