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Stem Cell Therapy in Neuroimmunological Diseases and Its Potential Neuroimmunological Complications. Cells 2022; 11:cells11142165. [PMID: 35883607 PMCID: PMC9318423 DOI: 10.3390/cells11142165] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Revised: 07/03/2022] [Accepted: 07/06/2022] [Indexed: 12/29/2022] Open
Abstract
Background: Since the 1990s, transplantations of hematopoietic and mesenchymal stem cells (HSCT and MSCT) and dendritic cell (DCT) have been investigated for the treatment of neurological autoimmune disorders (NADs). With the growing number of transplanted patients, awareness of neuroimmunolgical complications has increased. Therefore, an overview of SCT for the most common NADs and reports of secondary immunity after SCT is provided. Methods: For this narrative review, a literature search of the PubMed database was performed. A total of 86 articles reporting on different SCTs in NADs and 61 articles dealing with immune-mediated neurological complications after SCT were included. For multiple sclerosis (MS), only registered trials and phase I/II or II studies were considered, whereas all available articles on other disorders were included. The different transplantation procedures and efficacy and safety data are presented. Results: In MS patients, beneficial effects of HSCT, MSCT, and DCT with a decrease in disability and stabilization of disease activity have been reported. These effects were also shown in other NADs mainly in case reports. In seven of 132 reported patients with immune-mediated neurological complications, the outcome was fatal. Conclusions: Phase III trials are ongoing for MS, but the role of SCT in other NADs is currently limited to refractory patients due to occasional serious complications.
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Trad S, Nosbaum A, Musset L, Ghillani-Dalbin P, Launay D, Costedoat-Chalumeau N, Saadoun D, Cabane J, Hachulla E, Hanslik T, Frances C. Systemic sclerosis and prevalence of monoclonal immunoglobulin. Autoimmun Rev 2014; 13:1189-94. [PMID: 25151977 DOI: 10.1016/j.autrev.2014.08.016] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2014] [Accepted: 07/07/2014] [Indexed: 12/23/2022]
Abstract
INTRODUCTION The purpose of this study was to estimate the prevalence of monoclonal immunoglobulin (MIg) among patients with systemic sclerosis (SSc) according to the capillary electrophoresis or immunofixation method of detection and to search for any related clinical correlations. PATIENTS AND METHODS Retrospective multicenter comparison of capillary electrophoresis and immunofixation results in SSc patients and of the characteristics of patients with and without MIg. RESULTS The study included 244 SSc patients (216 women and 28 men, mean age: 55±14 years). Median time since SSc diagnosis was 51 months [0-320]; disease was diffuse in 48% of cases. Ten percent of patients had cancer, including Waldenström macroglobulinemia (n=1) and multiple myeloma (n=3). Capillary electrophoresis showed a γ-globulin anomaly in 41% of cases, and immunofixation in 18%: MIg (13.5%) and restriction of heterogeneity (4.5%). Capillary electrophoresis failed to detect 60% of the 33 MIg patients. Measurable MIg concentrations were obtained from 7 patients. MIg patients were significantly older at SSc diagnosis than those without MIg (p=0.002), had a lower diffusing capacity (p=0.002), a higher prevalence of pulmonary hypertension and cancer (p=0.002) and were more frequently positive for anti-mitochondrial and anti-beta2-glycoprotein-I antibodies (p=0.03 and p=0.02, respectively). Multivariate analyses showed that only age at test [hazard ratio 1.03 (95% CI, 1.00-1.07, p=0.04)] and presence of cancer [hazard ratio 4.46 (95% CI, 1.6-12.4, p=0.004)] were associated with MIg. CONCLUSION Immunofixation detected a high prevalence of MIg among SSc patients especially in patients aged 50-years or older. MIg was not detected by the standard capillary electrophoresis in 60% of cases and was significantly associated with cancer.
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Affiliation(s)
- Salim Trad
- AP-HP, Internal Medicine Department 2, Groupe Hospitalier Pitié Salpêtrière, 75013 Paris, France.
| | - Audrey Nosbaum
- AP-HP, Internal Medicine Department, Hôpital Saint-Antoine, 75012 Paris, France
| | - Lucile Musset
- AP-HP, Immunochemistry Laboratory, Groupe Hospitalier Pitié Salpêtrière, 75013 Paris, France
| | - Pascale Ghillani-Dalbin
- AP-HP, Immunochemistry Laboratory, Groupe Hospitalier Pitié Salpêtrière, 75013 Paris, France
| | - David Launay
- Internal Medicine Department, Hôpital Claude Huriez, CHRU, 59000 Lille, France; University Hospital, Lille, 75013 Paris, France
| | - Nathalie Costedoat-Chalumeau
- AP-HP, Internal Medicine Department 2, Groupe Hospitalier Pitié Salpêtrière, 75013 Paris, France; Université Pierre et Marie Curie, Paris 6, 75013 Paris, France
| | - David Saadoun
- AP-HP, Internal Medicine Department 2, Groupe Hospitalier Pitié Salpêtrière, 75013 Paris, France; Université Pierre et Marie Curie, Paris 6, 75013 Paris, France
| | - Jean Cabane
- AP-HP, Internal Medicine Department, Hôpital Saint-Antoine, 75012 Paris, France; Université Pierre et Marie Curie, Paris 6, 75013 Paris, France
| | - Eric Hachulla
- Internal Medicine Department, Hôpital Claude Huriez, CHRU, 59000 Lille, France; University Hospital, Lille, 75013 Paris, France
| | - Thomas Hanslik
- AP-HP, Internal Medicine Department 2, Groupe Hospitalier Pitié Salpêtrière, 75013 Paris, France; Versailles-Saint-Quentin-en-Yvelines University, 78000 Versailles, France
| | - Camille Frances
- Université Pierre et Marie Curie, Paris 6, 75013 Paris, France; AP-HP, Service de Dermatologie-Allergologie, Hôpital Tenon, 75020 Paris, France
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Fulminant diffuse systemic sclerosis following aortic valve replacement. Med Hypotheses 2014; 82:792-4. [PMID: 24735843 DOI: 10.1016/j.mehy.2014.03.027] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2013] [Accepted: 03/24/2014] [Indexed: 11/20/2022]
Abstract
We present a case of fulminant diffuse systemic sclerosis (dSSc) developed after the aortic valve replacement followed by fatal congestive heart failure within the 6 months from the initial symptoms. A 61-year-old male developed rapidly progressive diffuse systemic sclerosis following aortic valve replacement due to stenosis of bicuspid aortic valve. He presented with diarrhoea, weight loss, mialgia and arthralgia after cardiac surgery. Heart failure, due to myocardial fibrosis, was noted as a cause of death. We hypothesize that artificial materials like the ones used in mechanical valves or silicon materials in breast implants may induce fulminant course of pre-existing systemic sclerosis or create a new onset in predisposed individual.
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Čolović M, Jurisic V, Bila J, Čolović N, Palibrk V. FGF-R3 and OPG expression in patient with multiple myeloma following systemic sclerosis: case report and review of the literature. Int J Hematol 2011; 93:228-231. [PMID: 21207214 DOI: 10.1007/s12185-010-0752-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2010] [Revised: 11/18/2010] [Accepted: 12/13/2010] [Indexed: 11/28/2022]
Abstract
The presence of multiple myeloma (MM) in a patient with systemic sclerosis is a rare and unusual occurrence with unclear significance. We report the case of a 55-year-old woman with a 20-year history of systemic sclerosis, who subsequently presented with clinical stage IIIA IgG-λ MM. The systemic sclerosis was diagnosed and treated in 1988 with D: -penicillamine and methotrexate. Twenty years later, in December 2008, she presented with symptoms of Raynaud's phenomenon and intense facial pruritus. Immunoelectrophoresis confirmed the presence of a IgG-λ paraprotein (71.90 g/l) and Bence Jones proteinuria of the lambda light chains. Bone marrow histology revealed infiltrates of plasmocytes and lymphoplasmocytes which were on immunohistochemistry CD38+, FGF-R3+ and OPG+. An extensive X-ray skeletal survey did not show any osteolytic lesions or fractures. The patient was treated according to the CTD protocol (cyclophosphamide, thalidomide, and dexamethasone) which was effective against the myeloma as well as the systemic sclerosis and patient achieved complete remission.
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Affiliation(s)
- Milica Čolović
- Institute of Hematology, Clinical Center of Serbia, Koste Todorovića 2, Belgrade, Serbia
| | - Vladimir Jurisic
- Institute of Hematology, Clinical Center of Serbia, Koste Todorovića 2, Belgrade, Serbia.
| | - Jelena Bila
- Institute of Hematology, Clinical Center of Serbia, Koste Todorovića 2, Belgrade, Serbia
| | - Natasa Čolović
- Institute of Hematology, Clinical Center of Serbia, Koste Todorovića 2, Belgrade, Serbia
| | - Vuk Palibrk
- Institute of Hematology, Clinical Center of Serbia, Koste Todorovića 2, Belgrade, Serbia
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Braiteh F, Hymes SR, Giralt SA, Jones R. Complete remission of psoriasis after autologous hematopoietic stem-cell transplantation for multiple myeloma. J Clin Oncol 2008; 26:4511-3. [PMID: 18802165 DOI: 10.1200/jco.2008.17.6560] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Fadi Braiteh
- Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, Graduate School of Biomedical Sciences, University of Texas, Houston, TX, USA
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Hong SH, Hong YS, Woo IS, Koh YH, Rho SY, Peak JY, Lee MA, Shim BY, Byun JH, Park JC, Lee JW, Min WS, Kim CC. Autologous stem cell transplantation using a modified TAM conditioning regimen for clinically aggressive non-Hodgkin's lymphoma. Cancer Res Treat 2007; 39:54-60. [PMID: 19746215 DOI: 10.4143/crt.2007.39.2.54] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2007] [Accepted: 06/30/2007] [Indexed: 11/21/2022] Open
Abstract
PURPOSE High-dose chemotherapy (HDT) and autologous stem cell transplantation (ASCT) have been used for the treatment of clinically aggressive non-Hodgkin's lymphoma (NHL). However, the superiority of specific conditioning regimens has not yet been established. The present study evaluated the efficacy and toxicity of a conditioning regimen involving fractionated total body irradiation (TBI), and the use of Ara-C and melphalan (TAM) for clinically aggressive NHL. MATERIALS AND METHODS Between March 2002 and December 2004, 31 patients with aggressive NHL received fractionated TBI with a dose of 12 Gy over 3 days, and were administered 9 g/m(2) Ara-C and 100 mg/m(2) melphalan followed by autologous peripheral blood stem Cell Transplantation at the Catholic Hematopoietic Stem cell transplantation Center Korea. Patients that responded to first line chemotherapy and achieved complete remission (CR), or were in a first sensitive relapse were defined as having less advanced disease, while the other patients were defined as having more advanced disease. RESULTS Objective responses were obtained in 24 of 31 patients (77.4%), comprising complete remission in 19 patients (61.3%) and partial remission in 5 (16.1%) patients. The median follow-up time was 28 months (range 1 approximately 62 months). At 3 years, the overall survival and event-free survival (EFS) rates were 62.3% and 47.3%, respectively. Patients with less advanced disease and more advanced disease showed 3-year EFS rates of 73.3% and 22.5 %, respectively (p=0.006). Early (within the first 100 days) treatment-related mortality occurred in 3 (9.7%) patients. Of the 31 total patients, 15 (48.4%) developed grade 3 mucositis, 22 (70.9%) developed neutropenic fever, and two (6.5%) developed interstitial pneumonia syndrome>grade 3. CONCLUSION The modified TAM conditioning regimen and ASCT appear to be a feasible treatment regimen for clinically aggressive NHL, particularly for patients with less advanced disease.
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Affiliation(s)
- Sook Hee Hong
- Division of Medical Oncology, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea
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