PT - JOURNAL ARTICLE AU - S Z Pavletic AU - L W Klassen AU - R Pope AU - J R O'Dell AU - A E Traynor AU - C E Haire AU - F Graziano AU - Y Oyama AU - W Barr AU - R K Burt TI - Treatment of relapse after autologous blood stem cell transplantation for severe rheumatoid arthritis. DP - 2001 Oct 01 TA - The Journal of Rheumatology PG - 28--31 VI - 64 4099 - http://www.jrheum.org/content/64/28.short 4100 - http://www.jrheum.org/content/64/28.full SO - J Rheumatol2001 Oct 01; 64 AB - 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.