Long-term outcomes of high-dose immunosuppressive therapy with autologous stem cell transplantation in refractory systemic lupus erythematosus

We investigated the long&term outcomes of high&dose immunosupression and autologous hematopoietic stem cell transplantation (HSCT) vs continuing the currently accepted standard of care in severe, refractory systemic lupus erythematosus (SLE). Fifteen patients, who underwent high-dose immunosupression and HSCT and fifteen patients who continued the currently accepted standard of care, were observed. The median follow up is 45±10,4 months. Complete remission was achieved in six patients (40%), in another six patients (40%) decrease of SLEDAI was registered. Relapse occurred in 7 patients (47%). Transplant-related mortality was 13% (2/15). Overall 5-years survival was 80%. Disease-free 5-years survival was 20%. Another 3 patients died after 2, 96, 108 months. In control group remission was not achieved, overall mortality was 20%, overall 5-years survival was 70%. We conclude, that in treatment&refractory SLE high-dose immunosupression and HSCT it is effective to achieve disease control and it proves superior to the current standard of care.