Haematopoietic stem-cell transplantation in Crohn's disease

In a Comment accompanying James Lindsay and colleagues' Article on the ASTIClite trial, 1 Lindsay JO Hind D Swaby L et al. Safety and efficacy of autologous haematopoietic stem-cell transplantation with low-dose cyclophosphamide mobilisation and reduced intensity conditioning versus standard of care in refractory Crohn's disease (ASTIClite): an open-label, multicentre, randomised controlled trial. Lancet Gastroenterol Hepatol. 2024; (published online Feb 7.)https://doi.org/10.1016/S2468-1253(23)00460-0 Google Scholar Rachele Ciccocioppo and Ludovit Gaspar cite the principle of first, do no harm, and recommend against stem-cell transplantation in Crohn's disease. 2 Ciccocioppo R Gaspar L Haematopoietic stem-cell transplantation for patients with Crohn's disease: primum non nocere. Lancet Gastroenterol Hepatol. 2024; (published online Feb 7.)https://doi.org/10.1016/S2468-1253(24)00004-9 Summary Full Text Full Text PDF Scopus (0) Google Scholar We disagree with this conclusion and believe that it overlooks the gravity of the situation faced by patients with refractory Crohn's disease. Safety and efficacy of autologous haematopoietic stem-cell transplantation with low-dose cyclophosphamide mobilisation and reduced intensity conditioning versus standard of care in refractory Crohn's disease (ASTIClite): an open-label, multicentre, randomised controlled trialAlthough HSCT with an immune-ablative regimen of reduced intensity decreased endoscopic disease activity, significant adverse events deem this regimen unsuitable for future clinical use in patients with refractory Crohn's disease. Full-Text PDF Open Access