Document Detail


Recurrence of autoimmune disease after autologous peripheral blood stem cell transplantation for multiple myeloma.
MedLine Citation:
PMID:  17118763     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
There have been a number of reports on the improvement of concomitant autoimmune disease (AID) after autologous hematopoietic stem cell transplantation (SCT) performed for hematologic malignancy. However, in some cases of hematologic malignancy with AID, exacerbation of AID after autologous SCT has been reported. We have treated 27 adults with multiple myeloma with single or tandem autologous SCT. After peripheral blood stem cells were collected and stored without CD34+ cell selection or T-cell depletion, all patients received melphalan (200 mg/m2) as a conditioning regimen. In 2 patients with a history of AID (one with rheumatoid arthritis [RA] and the other with bullous pemphigoid [BP]) and in 1 patient with Sjögren syndrome, AID recurred 7 to 12 months after autologous SCT. The RA and BP were in durable remission before SCT, and no Sjögren syndrome-related disease activity was clinically documented at the time of SCT. No progression of the myeloma was observed when the AIDs recurred. The patients required systemic steroid therapy for their AID, and successful control of the disease was achieved. Our experience suggests that autologous SCT with unmanipulated stem cells for myeloma is unlikely to cure preexisting AID; rather, the AID may worsen. Transplantation physicians should be aware of this possible complication.
Authors:
Ikuko Isshiki; Shinichiro Okamoto; Tsunenori Kakimoto; Chien-Kang Chen; Takehiko Mori; Kenji Yokoyama; Yutaka Hattori; Yasuo Ikeda
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  International journal of hematology     Volume:  84     ISSN:  0925-5710     ISO Abbreviation:  Int. J. Hematol.     Publication Date:  2006 Nov 
Date Detail:
Created Date:  2006-11-22     Completed Date:  2007-02-28     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9111627     Medline TA:  Int J Hematol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  354-8     Citation Subset:  IM    
Affiliation:
Division of Hematology, Department of Medicine, Keio University School of Medicine, Tokyo, Japan.
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MeSH Terms
Descriptor/Qualifier:
Aged
Antigens, CD34
Arthritis, Rheumatoid / drug therapy,  pathology
Autoimmune Diseases / etiology*,  pathology*
Female
Humans
Lymphocyte Depletion
Male
Melphalan / administration & dosage
Middle Aged
Multiple Myeloma / complications*,  therapy*
Pemphigoid, Bullous / drug therapy,  pathology
Peripheral Blood Stem Cell Transplantation / adverse effects*,  methods
Recurrence
Sjogren's Syndrome / drug therapy,  pathology
Steroids / therapeutic use
Transplantation Conditioning / methods
Transplantation, Autologous
Chemical
Reg. No./Substance:
0/Antigens, CD34; 0/Steroids; 148-82-3/Melphalan

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