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New autoimmune diseases after autologous hematopoietic stem cell transplantation for MS

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  • New autoimmune diseases after autologous hematopoietic stem cell transplantation for MS

    Published: 28 April 2021

    New autoimmune diseases after autologous hematopoietic stem cell transplantation for multiple sclerosis
    Bone Marrow Transplantation (2021)

    Abstract

    Secondary autoimmune diseases (2ndADs), most frequently autoimmune cytopenias (AICs), were first described after allogeneic hematopoietic stem cell transplantation (HSCT) undertaken for malignant and hematological indications, occurred at a prevalence of ~5–6.5%, and were attributed to allogeneic immune imbalances in the context of graft versus host disease, viral infections, and chronic immunosuppression. Subsequently, 2ndADs were reported to complicate roughly 2–14% of autologous HSCTs performed for an autoimmune disease. Alemtuzumab in the conditioning regimen has been identified as a risk for development of 2ndADs after either allogeneic or autologous HSCT and is consistent with the high rates of 2ndADs when using alemtuzumab as monotherapy. Due to the significant consequences but variable incidence, depending on conditioning regimen, of 2ndADs and similarity in known immune reconstitution kinetics after autologous HSCT for autoimmune diseases and after alemtuzumab monotherapy, we propose that an imbalance between B and T lineage regeneration early after HSCT may underlie the pathogenesis of 2ndADs.
    Dave Bexfield
    ActiveMSers

  • #2
    Thank you! And fascinating. I have had 2ndADs after alemtuzumab. Nothing serious but I’m constantly curious about what went on and when.

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