title: Autologous peripheral blood haematopoietic stem cell transplantation for systemic lupus erythematosus: the observation of long-term outcomes in a Chinese centre.
abstract: OBJECTIVE
  We aimed to evaluate the safety and long-term efficacy of autologous peripheral blood haematopoietic stem cell transplantation (APHSCT).
  
  
  METHODS
  We did not want to evaluate the efficacy of antibodies but rather the clinical response by investigating progression-free survival and serologic response by assessing autoantibody titres and complement levels.
  
  
  RESULTS
  Overall, 22 patients with SLE (17 females; median age, 23 years) undergoing APHSCT were included. The 3-year progression-free survival (PFS) was 77.27% at our centre. We found that all the patients survived over three years. The 5-year PFS and overall survival (OS) rate was 67.90% and 95.20%. The titres of antinuclear antibody (ANA), anti-double-stranded deoxyribonucleic acid antibody (anti-dsDNA), anti-Sm antibody, and 24-h urinary protein significantly decreased, while complements 3 (C3) and C4 normalised at 100 days after transplantation (p<0.05). Kidney re-biopsy revealed a decrease in immune complex deposits in patients with remission. The incidence of CMV reactivation was 59.09% after transplantation in 3 years. Pregnancy and childbirth were reported in three female patients after transplantation. The risk of post-transplantation complications persisted for many years.
  
  
  CONCLUSIONS
  Immunoablation followed by APHSCT has the potential to induce long-term clinical and serologic remissions despite withdrawal of immunosuppressive maintenance therapy. While relapses may occur, in our small cohort of patients we found no predictive markers for relapse development by analysing antibody and complement levels and urinary proteinuria.
authors.affiliation: Department of Dermatology, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China.
authors.forename: Can
authors.initials: C
authors.lastname: Cao
authors.affiliation: Department of Dermatology, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China.
authors.forename: Menglei
authors.initials: M
authors.lastname: Wang
authors.affiliation: Department of Haematology, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China.
authors.forename: Jing
authors.initials: J
authors.lastname: Sun
authors.affiliation: Department of Dermatology, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China.
authors.forename: Xuebiao
authors.initials: X
authors.lastname: Peng
authors.affiliation: Department of Haematology, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China.
authors.forename: Qifa
authors.initials: Q
authors.lastname: Liu
authors.affiliation: Department of Dermatology, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China.
authors.forename: Liang
authors.initials: L
authors.lastname: Huang
authors.affiliation: Department of Haematology, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China.
authors.forename: Yanyan
authors.initials: Y
authors.lastname: Chai
authors.affiliation: Department of Dermatology, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China.
authors.forename: Kuan
authors.initials: K
authors.lastname: Lai
authors.affiliation: Department of Dermatology, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China.
authors.forename: Pingjiao
authors.initials: P
authors.lastname: Chen
authors.affiliation: Department of Dermatology, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China.
authors.forename: Qingxiu
authors.initials: Q
authors.lastname: Liu
authors.affiliation: Department of Dermatology, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China.
authors.forename: Qian
authors.initials: Q
authors.lastname: Li
authors.affiliation: Department of Dermatology, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China.
authors.forename: Yusheng
authors.initials: Y
authors.lastname: Peng
authors.affiliation: Department of Dermatology, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China.
authors.forename: Hao
authors.initials: H
authors.lastname: Xiong
authors.affiliation: Department of Dermatology, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China.
authors.forename: Jing
authors.initials: J
authors.lastname: Zhang
authors.affiliation: Department of Dermatology, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China.
authors.forename: Minghua
authors.initials: M
authors.lastname: Chen
authors.affiliation: Department of Dermatology, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China. vitc1029@163.com.
authors.forename: Kang
authors.initials: K
authors.lastname: Zeng
mesh_terms: D000293:Adolescent; D000328:Adult; D001323:Autoantibodies / Q000097:blood; D015415:Biomarkers / Q000097:blood; D002648:Child; D002681:China; D003165:Complement System Proteins / Q000378:metabolism; D018450:Disease Progression; D018572:Disease-Free Survival; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects / Q000401:mortality; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage / Q000009:adverse effects; D008180:Lupus Erythematosus, Systemic / Q000097:blood / Q000175:diagnosis / Q000401:mortality / Q000601:surgery*; D008297:Male; D011183:Postoperative Complications / Q000209:etiology; D011247:Pregnancy; D012074:Remission Induction; D012307:Risk Factors; D012698:Serologic Tests; D016019:Survival Analysis; D013997:Time Factors; D014182:Transplantation, Autologous; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D001323:Autoantibodies; D015415:Biomarkers; D007166:Immunosuppressive Agents; D003165:Complement System Proteins