title: [Autologous stem cell transplantation in systemic sclerosis].
abstract: Autologous hematopoietic stem cell transplantation (HSCT) is a very effective treatment option for patients with severe systemic sclerosis (SSc). In addition to various case series two randomized controlled trials could prove its superiority over intense cyclophosphamide pulse therapy. Nevertheless, HSCT is associated with a treatment-related mortality of approximately 10 %; therefore, further studies should be carried out to reduce the toxicity of HSCT by adaptation of the therapy regimen and the option of HSCT should be made available earlier to patients with a high risk of mortality. The mechanism of action of HSCT is still poorly understood. While profibrotic cytokines or even autoantibodies hardly appear to be influenced by the treatment, alterations to regulatory T‑cells may play a role. Further improvement of transplantation regimens as well as a better understanding of the underlying pathogenetic principles and mechanisms of action should be the aim of further studies on HSCT.
authors: Zentrum für Interdisziplinäre Rheumatologie, klinische Immunologie und Autoimmunerkrankungen (INDIRA) und Innere Medizin II (Onkologie, Hämatologie, Rheumatologie, Immunologie und Pulmologie), Universitätsklinik Tübingen, Otfried-Müller-Str. 10, 72076, Tübingen, Deutschland. Joerg.henes@med.uni-tuebingen.de.
authors: J C
authors: JC
authors: Henes
authors: Innere Medizin II (Onkologie, Hämatologie, Rheumatologie, Immunologie und Pulmologie), Universitätsklinik Tübingen, Tübingen, Deutschland.
authors: S
authors: S
authors: Wirths
authors: 4. Medizinische Abteilung, Rheumatologie, Klinische Immunologie, Nephrologie, Asklepios Klinik Altona, Hamburg, Deutschland.
authors: I
authors: I
authors: Kötter
mesh_terms: D001327:Autoimmune Diseases / Q000175:diagnosis* / Q000628:therapy*; D019317:Evidence-Based Medicine; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects / Q000379:methods*; D006801:Humans; D012219:Rheumatology / Q000639:trends; D012595:Scleroderma, Systemic / Q000175:diagnosis* / Q000628:therapy*; D014182:Transplantation, Autologous / Q000009:adverse effects / Q000379:methods; D016896:Treatment Outcome
keywords: CD34 selection; Cyclophosphamide; Mortality; T cells; Toxicity