Transplanted Blood Stem Cells (HSCs) and the Treatment of Systemic Sclerosis
Transplanted blood stem cells (hematopoietic stem cells/HSCs) have been shown to enhance the functional status of patients with systemic sclerosis (a severe chronic disease), significantly improving hand function, physical capacity, and quality of life.
J Clin Rheumatol. 2019 Aug 6. doi: 10.1097/RHU.0000000000001117. [Epub ahead of print]
Costa-Pereira KR1, Guimarães AL1,2, Moraes DA1, Dias JBE1, Garcia JT1,2, de Oliveira-Cardoso EA2, Zombrilli A1,3, Leopoldo V1,3, Costa TM1,4, Simões BP1,4, Oliveira MC1,4.
- From the Departamento de Clínica Médica, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, Brazil.
- Departamento de Psicologia, Faculdade de Filosofia Ciências e Letras de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, Brazil.
- Escola de Enfermagem de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, Brasil.
- Centro de Terapia Celular, Universidade de São Paulo, Ribeirão Preto, Brazil.
We sought to evaluate if autologous hematopoietic stem cell transplantation (AHSCT) influences the functional status of systemic sclerosis (SSc) patients.
From 2014 to 2018, a cohort of 27 SSc patients was assessed before, and at 6 and 12 months after AHSCT for modified Rodnan’s skin score (mRSS), mouth opening, hand grip strength, range of motion (ROM), functional ability of upper limbs (DASH questionnaire and Cochin hand function scale-CHFS), 6-minute walk test (6MWT), and quality of life (SF-36 questionnaire). Linear regression models with random effects and Spearman’s test were used for statistical analysis.
At 6 and 12 months after AHSCT, respectively, we observed significant improvement of mRSS (p < 0.01 and p < 0.01), mouth opening (p = 0.02 and p < 0.01), hand function (DASH, p < 0.01 and p < 0.01; CHFS, p < 0.01 and p < 0.01; strength, p < 0.01 and p < 0.01), physical capacity (6MWT, p = 0.02 and p = 0.03) and physical (p < 0.01 and p < 0.01) and mental (ns and p = 0.02) component scores of SF-36. At 12 months after AHSCT, ROM measurements improved (p < 0.05) in five out of six evaluated joints in both hands, compared to baseline. Correlation was significant between physical capacity and quality of life (R = 0.62; p < 0.01), between DASH and quality of life (R = -0.48; p = 0.03), and between skin involvement and wrist ROM measures (dominant hand, R = -0.65, p < 0.01; non-dominant hand, R = -0.59; p < 0.01).
AHSCT enhances the functional status of SSc patients in the first year of follow-up, significantly improving hand function, physical capacity and quality of life. These results are interpreted as positive outcomes of AHSCT for SSc.