Prognostic Factors for Clinical Response in Systemic Lupus Erythematosus Patients Treated by Allogeneic Mesenchymal Stem Cells
Systemic lupus erythematosus (SLE) is an autoimmune disease with a broad range of clinical manifestations and a heterogeneous disease course. There is no cure for SLE, but current standard pharmacotherapies can improve disease prognosis in most patients. However, some patients are refractory to conv...
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Wiley
2019-01-01
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| Series: | Stem Cells International |
| Online Access: | http://dx.doi.org/10.1155/2019/7061408 |
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| author | Lihui Wen Myriam Labopin Manuela Badoglio Dandan Wang Lingyun Sun Dominique Farge-Bancel |
| author_facet | Lihui Wen Myriam Labopin Manuela Badoglio Dandan Wang Lingyun Sun Dominique Farge-Bancel |
| author_sort | Lihui Wen |
| collection | DOAJ |
| description | Systemic lupus erythematosus (SLE) is an autoimmune disease with a broad range of clinical manifestations and a heterogeneous disease course. There is no cure for SLE, but current standard pharmacotherapies can improve disease prognosis in most patients. However, some patients are refractory to conventional treatments and require alternative treatment options. The present study is aimed at identifying predictors of clinical response to allogeneic bone marrow-derived or umbilical cord-derived mesenchymal stem cell (BM-/UC-MSC) transplant in SLE. All adult patients identified in the Nanjing database with an SLE Disease Activity Index (SLEDAI) score≥8 at baseline that had undergone MSC transplant and who had at least 1 year of follow-up after one or two successive intravenous injections of allogeneic BM-/UC-MSCs (1 million/kg) were analyzed. SLE symptoms and SLEDAI were assessed at baseline and during follow-up to determine low disease activity (LDA) and clinical remission (CR) at 1, 3, 6, and 12 months. Sixty-nine patients were included in the study, with a median (range) SLEDAI of 13 (8-34) at baseline. Among the 69 patients, 40 (58%) achieved LDA and 16 (23%) achieved CR with a SLEDAI of 9 (4–20), 8 (0-16), 6 (0-18), and 5 (0-18) after 1, 3, 6, and 12 months, respectively. Older age (p=0.006) and no arthralgia/arthritis at baseline (p=0.03) were associated with a higher rate of LDA. Achieving CR was associated with older age (p=0.033), no arthralgia/arthritis at baseline (p=0.001), and no prior use of cyclophosphamide (p=0.003) or hydroxychloroquine (p=0.016). Future studies using unique immunosuppressive regimens and allogeneic MSC sources will further elucidate determinants of clinical response to MSC transplant in SLE. |
| format | Article |
| id | doaj-art-5b346521bb03463fabc1e8b1ea3b80fe |
| institution | Kabale University |
| issn | 1687-966X 1687-9678 |
| language | English |
| publishDate | 2019-01-01 |
| publisher | Wiley |
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| series | Stem Cells International |
| spelling | doaj-art-5b346521bb03463fabc1e8b1ea3b80fe2025-02-03T06:14:10ZengWileyStem Cells International1687-966X1687-96782019-01-01201910.1155/2019/70614087061408Prognostic Factors for Clinical Response in Systemic Lupus Erythematosus Patients Treated by Allogeneic Mesenchymal Stem CellsLihui Wen0Myriam Labopin1Manuela Badoglio2Dandan Wang3Lingyun Sun4Dominique Farge-Bancel5Department of Rheumatology and Immunology, The Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing 210008, ChinaEBMT Paris office, Department of Haematology, Hôpital Saint-Antoine, Paris, FranceINSERM UMR S 938, Université Pierre et Marie Curie, 184, Rue du Faubourg-Saint-Antoine, Paris, FranceDepartment of Rheumatology and Immunology, The Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing 210008, ChinaDepartment of Rheumatology and Immunology, The Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing 210008, ChinaUnité de Médecine Interne: Maladies Auto-Immunes et Pathologie Vasculaire (UF 04), Centre de Référence des Maladies Auto-Immunes Systémiques Rares d’Ile-de-France (Site Constitutif), Filière FAI2R, Hôpital Saint-Louis Assistance Publique Hôpitaux de Paris (AP-HP), 1, Avenue Claude-Vellefaux, 75010 Paris, FranceSystemic lupus erythematosus (SLE) is an autoimmune disease with a broad range of clinical manifestations and a heterogeneous disease course. There is no cure for SLE, but current standard pharmacotherapies can improve disease prognosis in most patients. However, some patients are refractory to conventional treatments and require alternative treatment options. The present study is aimed at identifying predictors of clinical response to allogeneic bone marrow-derived or umbilical cord-derived mesenchymal stem cell (BM-/UC-MSC) transplant in SLE. All adult patients identified in the Nanjing database with an SLE Disease Activity Index (SLEDAI) score≥8 at baseline that had undergone MSC transplant and who had at least 1 year of follow-up after one or two successive intravenous injections of allogeneic BM-/UC-MSCs (1 million/kg) were analyzed. SLE symptoms and SLEDAI were assessed at baseline and during follow-up to determine low disease activity (LDA) and clinical remission (CR) at 1, 3, 6, and 12 months. Sixty-nine patients were included in the study, with a median (range) SLEDAI of 13 (8-34) at baseline. Among the 69 patients, 40 (58%) achieved LDA and 16 (23%) achieved CR with a SLEDAI of 9 (4–20), 8 (0-16), 6 (0-18), and 5 (0-18) after 1, 3, 6, and 12 months, respectively. Older age (p=0.006) and no arthralgia/arthritis at baseline (p=0.03) were associated with a higher rate of LDA. Achieving CR was associated with older age (p=0.033), no arthralgia/arthritis at baseline (p=0.001), and no prior use of cyclophosphamide (p=0.003) or hydroxychloroquine (p=0.016). Future studies using unique immunosuppressive regimens and allogeneic MSC sources will further elucidate determinants of clinical response to MSC transplant in SLE.http://dx.doi.org/10.1155/2019/7061408 |
| spellingShingle | Lihui Wen Myriam Labopin Manuela Badoglio Dandan Wang Lingyun Sun Dominique Farge-Bancel Prognostic Factors for Clinical Response in Systemic Lupus Erythematosus Patients Treated by Allogeneic Mesenchymal Stem Cells Stem Cells International |
| title | Prognostic Factors for Clinical Response in Systemic Lupus Erythematosus Patients Treated by Allogeneic Mesenchymal Stem Cells |
| title_full | Prognostic Factors for Clinical Response in Systemic Lupus Erythematosus Patients Treated by Allogeneic Mesenchymal Stem Cells |
| title_fullStr | Prognostic Factors for Clinical Response in Systemic Lupus Erythematosus Patients Treated by Allogeneic Mesenchymal Stem Cells |
| title_full_unstemmed | Prognostic Factors for Clinical Response in Systemic Lupus Erythematosus Patients Treated by Allogeneic Mesenchymal Stem Cells |
| title_short | Prognostic Factors for Clinical Response in Systemic Lupus Erythematosus Patients Treated by Allogeneic Mesenchymal Stem Cells |
| title_sort | prognostic factors for clinical response in systemic lupus erythematosus patients treated by allogeneic mesenchymal stem cells |
| url | http://dx.doi.org/10.1155/2019/7061408 |
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