医学
美罗华
肺活量
DLCO公司
内科学
造血干细胞移植
联合疗法
危险系数
养生
移植
外科
肺
置信区间
扩散能力
肺功能
淋巴瘤
作者
Shiri Keret,Israel Henig,Tsila Zuckerman,Lisa Kaly,Aniela Shouval,Abid Awisat,Itzhak Rosner,Michael Rozenbaum,Nina Boulman,Ariela Dortort Lazar,Yair Molad,Firas Sabbah,Mohammad E. Naffaa,Emília Hardak,Gleb Slobodin,Doron Rimar
出处
期刊:Rheumatology
[Oxford University Press]
日期:2023-09-06
被引量:1
标识
DOI:10.1093/rheumatology/kead457
摘要
Abstract Objectives Autologous hematopoietic stem cell transplantation (AHSCT) has been shown to improve long-term survival for early diffuse progressive SSc compared with CYC. CYC, however, does not provide a long-term benefit in SSc. The combination of MMF and rituximab is a potent alternative regimen. We aimed to retrospectively compare the outcomes of SSc patients who underwent AHSCT to patients who met the eligibility criteria for AHSCT but received upfront combination therapy with MMF and rituximab. Methods Repeated assessments of modified Rodnan Skin Score (mRSS), forced vital capacity (FVC), and diffusing capacity (DLCO) values were conducted. Clinical improvement was defined as an mRSS decrease >25% or an FVC increase >10%. Event-free survival (EFS) was defined in the absence of persistent major organ failure or death. Results Twenty-one SSc patients in the combination therapy group were compared with 16 in the AHSCT group. Age, sex and disease duration were similar between the two groups. Clinical improvement at 12 months was seen in 18 (86%) patients in the combination group compared with 13 (81%) in the AHSCT group (P = 0.7). The hazard ratio for EFS at 24 months favoured the combination group (HR = 0.09, P = 0.04). During follow-up, both groups exhibited a significant and comparable reduction in mRSS and an increase in FVC values at each time interval up to 24 months. Conclusion MMF and rituximab compared with AHSCT in SSc patients eligible for AHSCT resulted in similar skin and lung clinical improvement with a better safety profile at 24 months.
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