Long term outcomes of the French ASTIS systemic sclerosis cohort using the global rank composite score.


Journal

Bone marrow transplantation
ISSN: 1476-5365
Titre abrégé: Bone Marrow Transplant
Pays: England
ID NLM: 8702459

Informations de publication

Date de publication:
09 2021
Historique:
received: 19 02 2021
accepted: 11 05 2021
revised: 29 04 2021
pubmed: 11 6 2021
medline: 14 10 2021
entrez: 10 6 2021
Statut: ppublish

Résumé

Two randomised trials (ASTIS, SCOT) of Autologous Hematopoietic Stem Cell Transplantation (AHSCT) versus monthly Cyclophosphamide for severe Systemic Sclerosis (SSc) patients used similar inclusion criteria, but different primary endpoints: event-free-survival (EFS) at 24 months in ASTIS versus the global rank composite score (GRCS) at 54 months in SCOT. Here we analysed the French ASTIS cohort (n = 49) outcome using the same GRCS endpoint as reported in SCOT. All patients, randomised to AHSCT (n = 26) or Cyclophosphamide (n = 23), were evaluated for the non-parametric GRCS endpoint based on: death, EFS, forced vital capacity (FVC), Health Assessment Questionnaire Disability Index (HAQ-DI) and modified Rodnan skin score (mRSS) at 60 months. Secondary endpoints were: EFS, overall survival (OS), HAQ DI and organ status. In intention-to-treat analysis, the GRCS demonstrated superiority for AHSCT (median: 9 versus -19, p = 0.018), mRSS (Δ mRSS: -16 versus -9, p = 0.02), and HAQ-DI (ΔHAQ-DI: -0.89 versus -0.2, p = 0.05) with no significant difference in OS, EFS, lung, heart and kidney function between the groups. In conclusion, this study demonstrates long term benefits of non-myeloablative AHSCT when assessed by the five longitudinal measures within GRCS affording direct primary endpoint comparison between ASTIS and SCOT.

Identifiants

pubmed: 34108673
doi: 10.1038/s41409-021-01355-1
pii: 10.1038/s41409-021-01355-1
doi:

Substances chimiques

Cyclophosphamide 8N3DW7272P

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

2259-2267

Informations de copyright

© 2021. The Author(s), under exclusive licence to Springer Nature Limited.

Références

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Auteurs

Nassim Ait Abdallah (N)

Unité de Médecine Interne: Maladies Auto-immunes et Pathologie Vasculaire (UF 04), Centre de Référence des Maladies auto-immunes systémiques Rares d'Ile-de-France MATHEC, AP-HP, Hôpital Saint-Louis, Paris, France.
Université de Paris, IRSL, Recherche clinique appliquée à l'hématologie, EA, Paris, France.

Mianbo Wang (M)

Lady Davis Institute, Montréal, QC, Canada.

Pauline Lansiaux (P)

Unité de Médecine Interne: Maladies Auto-immunes et Pathologie Vasculaire (UF 04), Centre de Référence des Maladies auto-immunes systémiques Rares d'Ile-de-France MATHEC, AP-HP, Hôpital Saint-Louis, Paris, France.
Université de Paris, IRSL, Recherche clinique appliquée à l'hématologie, EA, Paris, France.

Mathieu Puyade (M)

Service de Médecine Interne, CIC-1402, CHU de Poitiers, Poitiers, France.

Sabine Berthier (S)

Service de médecine interne et immunologie clinique, Hôpital F. Mitterrand, Dijon, France.

Louis Terriou (L)

Service de médecine interne et immunologie clinique, Hôpital Claude Huriez, CHRU Lille, France.

Catney Charles (C)

Unité de Médecine Interne: Maladies Auto-immunes et Pathologie Vasculaire (UF 04), Centre de Référence des Maladies auto-immunes systémiques Rares d'Ile-de-France MATHEC, AP-HP, Hôpital Saint-Louis, Paris, France.
Université de Paris, IRSL, Recherche clinique appliquée à l'hématologie, EA, Paris, France.

Richard K Burt (RK)

Division of Immunotherapy, Northwestern University, Chicago, IL, USA.

Marie Hudson (M)

Lady Davis Institute, Montréal, QC, Canada.
McGill University, Montréal, QC, Canada.
Jewish General Hospital, Montréal, QC, Canada.

Dominique Farge (D)

Unité de Médecine Interne: Maladies Auto-immunes et Pathologie Vasculaire (UF 04), Centre de Référence des Maladies auto-immunes systémiques Rares d'Ile-de-France MATHEC, AP-HP, Hôpital Saint-Louis, Paris, France. dominique.farge-bancel@aphp.fr.
Université de Paris, IRSL, Recherche clinique appliquée à l'hématologie, EA, Paris, France. dominique.farge-bancel@aphp.fr.
Department of Medicine, McGill University, Montreal, QC, Canada. dominique.farge-bancel@aphp.fr.

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