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Autologous stem cell transplantation in diffuse scleroderma: impact on hand structure and function.

H Englert1, S Kirkham, J Moore

  • 1Department of Rheumatology, Westmead Hospital, Sydney, New South Wales, Australia. helenen@westgate.wh.usyd.edu.au

Internal Medicine Journal
|March 14, 2008
PubMed
Summary
This summary is machine-generated.

Autologous stem cell transplantation (ASCT) improved scleroderma finger clawing and hand function within 12 months. ASCT resolved tenosynovitis, with functional gains most significant in employment and self-care.

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Area of Science:

  • Rheumatology
  • Immunology
  • Regenerative Medicine

Background:

  • Scleroderma causes significant hand deformities, including finger clawing.
  • Autologous stem cell transplantation (ASCT) is an emerging treatment for systemic sclerosis.

Purpose of the Study:

  • To evaluate the structural and functional impact of ASCT on scleroderma-related finger clawing.
  • To assess changes in tenosynovitis, skin scores, and hand function post-ASCT.

Main Methods:

  • Photographic assessment of hands from five scleroderma patients before and after ASCT.
  • Standardized questionnaire for functional assessments.
  • Measurement of hand dimensions and finger abduction.

Main Results:

  • ASCT resolved synovitis and tenosynovitis in most patients.
  • Modified Rodnan hand skin scores decreased post-ASCT.
  • Significant improvements in hand function were observed, particularly in employment and self-care.
  • Finger abduction measures proved more sensitive to clawing than hand length.

Conclusions:

  • ASCT effectively improves hand scleroderma, including refractory tenosynovitis, over 12 months.
  • Hand function, especially related to daily activities and employment, significantly improves post-ASCT.
  • Finger abduction is a key indicator for assessing scleroderma-related finger clawing.