Application of autologous hematopoietic stem cell transplantation for pemphigus

Int J Dermatol. 2017 Mar;56(3):296-301. doi: 10.1111/ijd.13461. Epub 2017 Jan 17.

Abstract

Background: Pemphigus is a rare and fatal autoimmune disease for which the treatment options are limited. This study aimed to evaluate the efficacy of autologous peripheral hematopoietic stem cell transplantation (APHSCT) for pemphigus.

Methods: We conducted APHSCT for 12 pemphigus patients (seven males and five females, mean age 23.8 years) with life-threatening complications or who responded poorly to conventional therapy. Peripheral blood stem cells were mobilized with cyclophosphamide, granulocyte colony-stimulating factor, and rituximab, and purified autologous CD34+ stem cells were infused. Overall survival rate, progression-free survival, and adverse events were recorded.

Results: With a mean follow-up period of 80.3 months, overall survival and complete clinical remission rates were 92% (11/12) and 75% (9/12), respectively. Adverse effects included pyrexia, allergy, infection, and elevation of enzymes. Only one patient died of severe sepsis and multiple organ failure 2 months after APHSCT.

Conclusion: Overall APHSCT is a promising therapeutic option for pemphigus.

Keywords: autologous peripheral hematopoietic stem cell transplantation; pemphigus.

MeSH terms

  • Adult
  • Disease-Free Survival
  • Female
  • Fever / etiology
  • Follow-Up Studies
  • Hematopoietic Stem Cell Transplantation* / adverse effects
  • Humans
  • Hypersensitivity / etiology
  • Male
  • Pemphigus / complications
  • Pemphigus / therapy*
  • Recurrence
  • Remission Induction
  • Sepsis / etiology
  • Survival Rate
  • Transplantation Conditioning*
  • Transplantation, Autologous
  • Young Adult