RT Journal Article
SR Electronic
T1 Treatment of relapse after autologous blood stem cell transplantation for severe rheumatoid arthritis.
JF The Journal of Rheumatology
JO J Rheumatol
FD The Journal of Rheumatology
SP 28
OP 31
VO 64
A1 S Z Pavletic
A1 L W Klassen
A1 R Pope
A1 J R O'Dell
A1 A E Traynor
A1 C E Haire
A1 F Graziano
A1 Y Oyama
A1 W Barr
A1 R K Burt
YR 2001
UL http://www.jrheum.org/content/64/28.abstract
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.