autologous blood and marrow transplantation - Blog Science ...

478 Chapter 8: Autoimmune Disease
Table 1. Clinical characteristics of the JCA patients before autoHSCT
Patient 1 Patient 2 Patient 3 Patient 4
Sex Female Female Male Female
Age at disease onset 1 year 3 years 3.5 years 5.25 years
Onset form of JCA Systemic Polyarticular Systemic Systemic
ANA - - — +
RF - - — _
Treatment NSAIDs, NSAIDs, NSAIDs, NSAIDs,
corticosteroids, corticosteroids, corticosteroids, oral gold,
IVIG, methotrexate, methotrexate, ATG,
methotrexate, CsA CsA azathioprine
CsA methotrexate,
CsA,
pulses methyl-
prednisolone
Clinical Erosions, Erosions, Erosions, Erosions,
characteristics growth growth growth growth
disturbance disturbance disturbance disturbance
age at AHSCT 6 years, 7 years, 11 years, 11 years
7 months 9 months 2 months
DISCUSSION
The effect of autoHSCT on signs and symptoms of chronic joint inflammation
in four patients was very favorable. The initial improvement could be explained by
the immune suppression of the conditioning regimen, but the duration of the
remission, even after recovery of the T cells and T cell function, is indicative of an
immune modulatory effect of autoHSCT. However, the follow-up period is too
short for definite conclusions. An interesting phenomenon is the occurrence of a
benign, oligoarticular synovitis in two of the four patients. This occurred simulta-
Table 2. Complications after autoHSCT in children with refractory arthritis
Patient 1
Varicella Zoster at 3 months, transient oligoarticular synovitis at 4 months follow-up
Patient 2
Varicella Zoster at 6 months follow-up
Patient 3
Transient oligoarticular synovitis at 6 months follow-up
Patient 4
Throat infection with hemolytic streptococci B at 4 months follow-up