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Autologous haematopoietic stem cell transplantation in refractory Crohn's disease: Experience in our centre
Nerea Hernanz1, María Sierra1, Nadja Volpato1
1Servicio de Gastroenterología y Hepatología, Hospital Universitario Ramón y Cajal, Madrid, España.
Insights
Autologous haematopoietic stem cell transplantation (AHSCT) offers a promising treatment for refractory Crohn's disease (CD). While many patients achieve remission, symptom recurrence necessitates ongoing medical management for some.
Area of Science:
- Gastroenterology
- Immunology
- Regenerative Medicine
Background:
- Refractory Crohn's disease (CD) poses significant treatment challenges.
- Autologous haematopoietic stem cell transplantation (AHSCT) is an established therapy for refractory CD.
Purpose of the Study:
- To retrospectively analyze the outcomes of AHSCT in patients with refractory CD.
- To evaluate the efficacy and long-term remission rates following AHSCT.
Main Methods:
- Retrospective analysis of data from patients with refractory CD treated with AHSCT.
- Data collected from Hospital Universitario Ramón y Cajal, Madrid.
Main Results:
- Seven patients with refractory CD underwent AHSCT.
- 43% achieved clinical and endoscopic remission, 14% showed clinical improvement, and 43% remained active initially.
- Symptom recurrence occurred in 71% of patients, requiring reinitiation of medical treatment; however, 71% were in clinical remission at 48-month follow-up.
Conclusions:
- AHSCT is a potentially valuable therapeutic option for refractory CD.
- It can induce clinical remission and re-sensitize patients to previously ineffective treatments.
- Long-term remission is achievable, though symptom recurrence may necessitate further medical intervention.
Introduction:
Autologous haematopoietic stem cell transplantation (AHSCT) is an accepted treatment in refractory Crohn's disease (CD).
Material And Methods:
Data on patients with refractory CD subjected to AHSCT are collected at the Hospital Universitario Ramón y Cajal in Madrid and the results obtained are described retrospectively.
Results:
Seven patients in total have received AHSCT due to refractory CD in our centre. Three patients (43%) presented with clinical and endoscopic remission; one patient (14%) clinical improvement without remission and three patients (43%) remained active with the need to restart treatment in the assessment of the initial response to the AHSCT (after six months). Symptoms recurred in five of the seven patients (71%) and all of them had to restart medical treatment after an average of 13.8 months (range: 3-30 months). Only one patient needed surgery after the AHSCT. At the end of the follow-up, after a mean of 48 months (range: 17-78 months), 5/7 (71%) of the patients were in clinical remission with or without treatment.
Conclusion:
AHSCT may be a promising therapeutic option for patients with refractory CD. Its usefulness lies in the fact that it can produce clinical remission without treatment in some patients, but also that it can make the disease treatable, obtaining a response to certain treatments in patients who had previously lost it.