Autologous stem cell transplantation improves cardiopulmonary exercise testing outcomes in systemic sclerosis patients

被引:1
作者
Gadioli, Leonardo Pippa [1 ]
Costa-Pereira, Karla [2 ]
Dias, Juliana B. E. [2 ]
Moraes, Daniela A. [2 ]
Crescencio, Julio C. [1 ]
Schwartzmann, Pedro, V [3 ,4 ]
Gallo, Lourenco [1 ]
Schmidt, Andre [1 ]
Oliveira, Maria Carolina [2 ,5 ]
机构
[1] Univ Sao Paulo, Ribeirao Preto Med Sch, Dept Internal Med, Div Cardiol, Ribeirao Preto, Brazil
[2] Univ Sao Paulo, Ribeirao Preto Med Sch, Dept Internal Med, Ave Bandeirantes 3900, BR-14048900 Ribeirao Preto, SP, Brazil
[3] Unimed Hosp, Cardiol Unit, Ribeirao Preto, Brazil
[4] CAPED Res Ctr, Ribeirao Preto, Brazil
[5] Univ Sao Paulo, Ctr Cellbased Therapy, Reg Hemotherapy Ctr, Ribeirao Preto Med Sch, Ribeirao Preto, Brazil
基金
巴西圣保罗研究基金会;
关键词
Scleroderma and related disorders; cardiovascular; cell transplantation; quality of life; outcome measures; PULSE CYCLOPHOSPHAMIDE; CAPACITY; STATEMENT;
D O I
10.1093/rheumatology/keac413
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Objectives Autologous haematopoietic stem cell transplantation (AHSCT) is a disease-modifying treatment for patients with severe SSc. Here, we aimed at assessing cardiopulmonary function outcomes of SSc patients after AHSCT. Methods Twenty-seven SSc adult patients treated with AHSCT were included in this retrospective study. Most had the diffuse cutaneous subset (93%) and pulmonary involvement (85%). Before and 12 months after AHSCT, patients underwent cardiopulmonary exercise testing, transthoracic echocardiography, pulmonary function test with diffusing capacity for carbon monoxide (DLCO), 6-min walk test (6MWT) and quality of life evaluations. Results After AHSCT, the peak VO2 increased from 954 to 1029 ml/min (P = 0.02), the percentage of predicted peak VO2 increased from 48.9 to 53.5 m (P = 0.01), and the distance measured by the 6MWT increased from 445 to 502 m (P = 0.01), compared with baseline. Improvements in peak VO2 correlated positively with improvements in 6MWT distance, and negatively with a decrease in resting heart rate. At baseline, patients with DLCO >70% had higher peak VO2 values than those with DLCO <70% (P = 0.04), but after AHSCT all patients showed improved VO2 values, regardless of baseline DLCO levels. Increases in VO2 levels after AHSCT positively correlated with increases in the physical component scores of the Short Form-36 quality of life questionnaire (r = 0.70; P = 0.0003). Conclusion AHSCT improves the aerobic capacity of SSc patients probably reflecting combined increments in lungs, skeletal muscle and cardiac function.
引用
收藏
页码:SI101 / SI106
页数:6
相关论文
共 50 条
[41]   Acute and fatal cardiotoxicity following high-dose cyclophosphamide in a patient undergoing autologous stem cell transplantation for systemic sclerosis despite satisfactory cardiopulmonary screening [J].
Martin, M. ;
Fornecker, L-m ;
Marcellin, L. ;
Mousseaux, E. ;
Hij, A. ;
Snowden, J. A. ;
Farge, D. ;
Martin, T. .
BONE MARROW TRANSPLANTATION, 2017, 52 (12) :1674-1677
[42]   Cardiopulmonary exercise testing and prognosis in patients with systemic sclerosis without baseline pulmonary hypertension: a prospective cohort study [J].
Bournia, Vasiliki-Kalliopi ;
Kallianos, Anastasios ;
Panopoulos, Stylianos ;
Gialafos, Elias ;
Velentza, Lemonia ;
Vlachoyiannopoulos, Panayiotis G. ;
Sfikakis, Petros P. ;
Trakada, Georgia .
RHEUMATOLOGY INTERNATIONAL, 2022, 42 (02) :303-309
[43]   Exercise Physiology Impairments of Patients With Amyotrophic Lateral Sclerosis: Cardiopulmonary Exercise Testing Findings [J].
He, Ji ;
Fu, Jiayu ;
Zhao, Wei ;
Ren, Chuan ;
Liu, Ping ;
Chen, Lu ;
Li, Dan ;
Zhou, Lequn ;
Tang, Lu ;
Liu, Xiangyi ;
Ye, Shan ;
Liu, Xiaolu ;
Ma, Yan ;
Zhang, Yixuan ;
Ma, Xinran ;
Zhang, Linjing ;
Zhang, Gaoqi ;
Li, Nan ;
Fan, Dongsheng .
FRONTIERS IN PHYSIOLOGY, 2022, 13
[44]   A successful case of second autologous haematopoietic stem cell transplantation for post-transplant systemic sclerosis relapse [J].
Hou, Y. ;
Li, H-J. ;
Li, M-T. ;
Xu, D. ;
Zhou, D-B. ;
Zeng, X-F. .
CLINICAL AND EXPERIMENTAL RHEUMATOLOGY, 2016, 34 (05) :S207-S207
[45]   Hematopoietic stem-cell transplantation in systemic sclerosis: an update [J].
Spierings, Julia ;
van Rhijn-Brouwer, Femke C. C. ;
van Laar, Jacob M. .
CURRENT OPINION IN RHEUMATOLOGY, 2018, 30 (06) :541-547
[46]   Neurovascular dysregulation in systemic sclerosis: novel insights into pathophysiology, diagnosis, and treatment utilizing invasive cardiopulmonary exercise testing [J].
Tarras, Elizabeth ;
Joseph, Phillip .
CURRENT OPINION IN RHEUMATOLOGY, 2025, 37 (01) :93-101
[47]   Haematopoietic stem cell transplantation in systemic sclerosis: Challenges and perspectives [J].
Di Benedetto, Paola ;
Ruscitti, Piero ;
Cipriani, Paola ;
Giacomelli, Roberto .
AUTOIMMUNITY REVIEWS, 2020, 19 (11)
[48]   Long-term outcome of autologous haematopoietic stem cell transplantation in patients with systemic sclerosis: a comparison with patients treated with rituximab and with traditional immunosuppressive agents [J].
Del Papa, Nicoletta ;
Cavalli, Silvia ;
Rindone, Andrea ;
Onida, Francesco ;
Saporiti, Giorgia ;
Minniti, Antonina ;
Pellico, Maria Rosa ;
Iannone, Claudia ;
Trignani, Giorgia ;
D'Angelo, Nicoletta ;
Sette, Manuel ;
Greco, Raffaella ;
Vitali, Claudio ;
Caporali, Roberto .
ARTHRITIS RESEARCH & THERAPY, 2024, 26 (01)
[49]   Low B cell counts as risk factor for infectious complications in systemic sclerosis after autologous hematopoietic stem cell transplantation [J].
Gernert, Michael ;
Tony, Hans-Peter ;
Schwaneck, Eva Christina ;
Froehlich, Matthias ;
Schmalzing, Marc .
ARTHRITIS RESEARCH & THERAPY, 2020, 22 (01)
[50]   The arguments favoring autologous haematopoietic stem cell transplantation in systemic scleroderma [J].
Pugnet, G. .
REVUE DE MEDECINE INTERNE, 2024, 45 (02) :104-108