Consensus statement concerning cardiotoxicity occurring during haematopoietic stem cell transplantation in the treatment of autoimmune diseases, with special reference to systemic sclerosis and multiple sclerosis (original) (raw)

Bone Marrow Transplantation volume 34, pages 877–881 (2004)Cite this article

Summary:

Autologous haematopoietic stem cell transplantation is now a feasible and effective treatment for selected patients with severe autoimmune diseases. Worldwide, over 650 patients have been transplanted in the context of phase I and II clinical trials. The results are encouraging enough to begin randomised phase III trials. However, as predicted, significant transplant-related morbidity and mortality have been observed. This is primarily due to complications related to either the stage of the disease at transplant or due to infections. The number of deaths related to cardiac toxicity is low. However, caution is required when cyclophosphamide or anthracyclines such as mitoxantrone are used in patients with a possible underlying heart damage, for example, systemic sclerosis patients. In November 2002, a meeting was held in Florence, bringing together a number of experts in various fields, including rheumatology, cardiology, neurology, pharmacology and transplantation medicine. The object of the meeting was to analyse existing data, both published or available, in the European Group for Blood and Marrow Transplantation autoimmune disease database, and to propose a safe approach to such patients. A full cardiological assessment before and during the transplant emerged as the major recommendation.

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Acknowledgements

We thank Mrs Liliana Fantini for secretarial support and the EBMT Autoimmune Diseases Working Party for supporting the meeting.

Author information

Authors and Affiliations

  1. Haematology Unit, University of Florence, Italy
    R Saccardi & F Pagliai
  2. Rheumatology Unit, University of Basel, Switzerland
    A Tyndall & C Bocelli-Tyndall
  3. Cardiology Unit, Royal Free Hospital, London, UK
    G Coghlan
  4. Rheumatology Unit, Royal Free Hospital, London, UK
    C Denton
  5. Neurology Unit, University Hospital, Rennes, France
    G Edan
  6. Cardiology Unit, CNR Institute of Clinical Physiology, Pisa, Italy
    M Emdin
  7. Internal Medicine Unit, St Louis Hospital, Paris, France
    D Farge
  8. Haematology Unit, George Papanicolaou Hospital, Thessaloniki, Greece
    A Fassas
  9. Haematology Unit, University of Freiburg, Germany
    J Finke
  10. Rheumatology Unit, University of California, Los Angeles, USA
    D Furst
  11. Oncology Drug Development, Milan, Italy
    M Lassus
  12. Neurology Unit, University of Genova, Italy
    G Mancardi
  13. Rheumatology Unit, University of Florence, Italy
    I Miniati, A Pignone & M Matucci-Cerinic
  14. Pharmacology Unit, University of Florence, Italy
    E Mini
  15. Haematology Unit, University of Basel, Switzerland
    J Passweg
  16. Rheumatology Unit, University Hospital, Leiden, The Netherlands
    J M van Laar

Authors

  1. R Saccardi
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  2. A Tyndall
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  3. G Coghlan
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  4. C Denton
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  5. G Edan
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  6. M Emdin
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  7. D Farge
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  8. A Fassas
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  9. J Finke
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  10. D Furst
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  11. M Lassus
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  12. G Mancardi
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  13. I Miniati
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  14. E Mini
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  15. F Pagliai
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  16. J Passweg
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  17. A Pignone
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  18. J M van Laar
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  19. C Bocelli-Tyndall
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  20. M Matucci-Cerinic
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Corresponding author

Correspondence toR Saccardi.

Additional information

Based on a meeting held in Florence, November 14–15, 2002, attended by all co-authors.

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Saccardi, R., Tyndall, A., Coghlan, G. et al. Consensus statement concerning cardiotoxicity occurring during haematopoietic stem cell transplantation in the treatment of autoimmune diseases, with special reference to systemic sclerosis and multiple sclerosis.Bone Marrow Transplant 34, 877–881 (2004). https://doi.org/10.1038/sj.bmt.1704656

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