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Autologous stem cel...
Autologous stem cell transplantation for refractory juvenile idiopathic arthritis: analysis of clinical effects, mortality, and transplant related morbidity
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de Kleer, I. M. (author)
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Brinkman, D. M. (author)
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Ferster, A. (author)
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Abinun, M. (author)
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Quartier, P. (author)
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Van Der Net, J. (author)
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ten Cate, R. (author)
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Wedderburn, L. R. (author)
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Horneff, G. (author)
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Oppermann, J. (author)
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Zintl, F. (author)
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Foster, H. E. (author)
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Prieur, A. M. (author)
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- Fasth, Anders, 1945 (author)
- Gothenburg University,Göteborgs universitet,Institutionen för kvinnors och barns hälsa, Avdelningen för pediatrik,Institute for the Health of Women and Children, Dept of Paediatrics
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van Rossum, M. A. (author)
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Kuis, W. (author)
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Wulffraat, N. M. (author)
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(creator_code:org_t)
- BMJ, 2004
- 2004
- English.
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In: Ann Rheum Dis. - : BMJ. - 0003-4967. ; 63:10, s. 1318-26
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https://ard.bmj.com/...
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https://gup.ub.gu.se...
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https://doi.org/10.1...
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Abstract
Subject headings
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- OBJECTIVE: To evaluate the safety and efficacy of autologous stem cell transplantation (ASCT) for refractory juvenile idiopathic arthritis (JIA). DESIGN: Retrospective analysis of follow up data on 34 children with JIA who were treated with ASCT in nine different European transplant centres. Rheumatological evaluation employed a modified set of core criteria. Immunological reconstitution and infectious complications were monitored at three month intervals after transplantation. RESULTS: Clinical follow up ranged from 12 to 60 months. Eighteen of the 34 patients (53%) with a follow up of 12 to 60 months achieved complete drug-free remission. Seven of these patients had previously failed treatment with anti-TNF. Six of the 34 patients (18%) showed a partial response (ranging from 30% to 70% improvement) and seven (21%) were resistant to ASCT. Infectious complications were common. There were three cases of transplant related mortality (9%) and two of disease related mortality (6%). CONCLUSIONS: ASCT in severely ill patients with JIA induces a drug-free remission of the disease and a profound increase in general wellbeing in a substantial proportion of patients, but the procedure carries a significant mortality risk. The following adjustments are proposed for future protocols: (1) elimination of total body irradiation from the conditioning regimen; (2) prophylactic administration of antiviral drugs and intravenous immunoglobulins until there is a normal CD4+ T cell count.
Keyword
- Arthritis
- Juvenile Rheumatoid/immunology/*therapy
- Child
- Child
- Preschool
- Female
- Follow-Up Studies
- Graft Survival
- Health Status Indicators
- Humans
- Infant
- Male
- Opportunistic Infections/etiology
- Patient Selection
- Retrospective Studies
- Severity of Illness Index
- Stem Cell Transplantation/adverse effects/*methods
- Survival Analysis
- T-Lymphocyte Subsets/immunology
- Transplantation Conditioning/methods
- Transplantation
- Autologous
- Treatment Outcome
Publication and Content Type
- ref (subject category)
- art (subject category)
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To the university's database
- By the author/editor
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de Kleer, I. M.
-
Brinkman, D. M.
-
Ferster, A.
-
Abinun, M.
-
Quartier, P.
-
Van Der Net, J.
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show more...
-
ten Cate, R.
-
Wedderburn, L. R ...
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Horneff, G.
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Oppermann, J.
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Zintl, F.
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Foster, H. E.
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Prieur, A. M.
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Fasth, Anders, 1 ...
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van Rossum, M. A ...
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Kuis, W.
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Wulffraat, N. M.
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show less...
- Articles in the publication
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Ann Rheum Dis
- By the university
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University of Gothenburg