TUESDAY, Jan. 31 (HealthDay News) -- High-dose cyclophosphamide followed by autologous hematopoietic stem cell transplantation (HSCT) can significantly improve symptoms of treatment-refractory systemic lupus erythematosus (SLE), although the treatment carries a high risk of infection, according to a study published in the Feb. 1 issue of the Journal of the American Medical Association.
Richard K. Burt, M.D., of Northwestern University Feinberg School of Medicine in Chicago, and colleagues studied 50 SLE patients who underwent the procedure between 1997 and 2005.
Two patients died after immune suppression and stem cell mobilization, one from disseminated mucormycosis and another from active lupus after postponing the transplant. In the 48 patients who underwent mobilization and HSCT, the researchers found that five-year survival was 84% and that the probability of disease-free survival at five years was 50%.
"The toxicity of high-dose cyclophosphamide, including the potential for death from infection, always must be balanced against the benefit and risk of these other potential therapies," states the author of an accompanying editorial. The study confirms that the treatment "has benefit in patients with severe refractory lupus. Whether this approach represents a definitive advance over more conventional immunosuppressive therapies will need to be answered in randomized controlled trials."
Abstract
Full Text (subscription or payment may be required)
Editorial
