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Haemopoietic stem cell transplantation in Systemic lupus erythematosus: a systematic review
Allergy, Asthma & Clinical Immunology ( IF 2.6 ) Pub Date : 2019-09-18 , DOI: 10.1186/s13223-019-0373-y
Nipun Lakshitha de Silva , Suranjith L. Seneviratne

Despite advances in treating Systemic lupus erythematosus (SLE), a proportion of patients continue to face significant morbidity and mortality. Haemopoietic stem cell transplant (HSCT) has been recognized as an option for such patients. We analysed the evidence on efficacy and safety of HSCT in patients with SLE. A database search was done for articles on HSCT in SLE up to July 2017 in PUBMED, Cochrane library, LILACS and clinical trial registration databases to select prospective or retrospective studies with 8 or more patients. Of the 732 search results from the PUBMED, Cochrane and LILACS database search, following duplicate removal, 15 studies were eligible for detailed assessment. Findings of an additional trial were obtained from the clinical trial registration database. Data were extracted on study design, patient characteristics, nature of intervention, outcomes, complications and study quality. Case reports and small case series were summarised without detailed qualitative analysis. Most of the studies showed remission in the majority of patients. Relapse of the original disease increased with longer follow-up. Common adverse effects included: infections and secondary autoimmune disorders. Short follow up period and lack of randomised controlled trials were the main limitations restricting the generalizability of study results. A meta-analysis was not performed due to heterogeneity of studies. Although HSCT is a viable option in SLE, its exact clinical utility needs to be further evaluated in well-designed studies.

中文翻译:

系统性红斑狼疮造血干细胞移植:系统评价

尽管在治疗系统性红斑狼疮(SLE)方面取得了进展,但仍有一部分患者继续面临明显的发病率和死亡率。造血干细胞移植(HSCT)已被认为是此类患者的一种选择。我们分析了HSCT在SLE患者中的有效性和安全性的证据。截至2017年7月,在PUBMED,Cochrane图书馆,LILACS和临床试验注册数据库中对SLE中HSCT的文章进行了数据库搜索,以选择对8名或更多患者进行的前瞻性或回顾性研究。在从PUBMED,Cochrane和LILACS数据库中搜索到的732个搜索结果中,重复删除后,有15个研究有资格进行详细评估。从临床试验注册数据库中获得了其他试验的结果。提取有关研究设计,患者特征,干预的性质,结果,并发症和研究质量。总结了病例报告和小病例系列,但没有详细的定性分析。大多数研究表明大多数患者缓解。随着更长的随访时间,原发病的复发率增加。常见的不良反应包括:感染和继发性自身免疫性疾病。随访时间短和缺乏随机对照试验是限制研究结果推广的主要限制。由于研究的异质性,未进行荟萃分析。尽管HSCT在SLE中是可行的选择,但其确切的临床实用性需要在设计良好的研究中进一步评估。大多数研究表明大多数患者缓解。随着更长的随访时间,原发病的复发率增加。常见的不良反应包括:感染和继发性自身免疫性疾病。随访时间短和缺乏随机对照试验是限制研究结果推广的主要限制。由于研究的异质性,未进行荟萃分析。尽管HSCT在SLE中是可行的选择,但其确切的临床实用性需要在设计良好的研究中进一步评估。大多数研究表明大多数患者缓解。随着更长的随访时间,原发病的复发率增加。常见的不良反应包括:感染和继发性自身免疫性疾病。随访时间短和缺乏随机对照试验是限制研究结果推广的主要限制。由于研究的异质性,未进行荟萃分析。尽管HSCT在SLE中是可行的选择,但其确切的临床实用性需要在设计良好的研究中进一步评估。随访时间短和缺乏随机对照试验是限制研究结果推广的主要限制。由于研究的异质性,未进行荟萃分析。尽管HSCT在SLE中是可行的选择,但其确切的临床实用性需要在设计良好的研究中进一步评估。随访时间短和缺乏随机对照试验是限制研究结果推广的主要限制。由于研究的异质性,未进行荟萃分析。尽管HSCT在SLE中是可行的选择,但其确切的临床实用性需要在设计良好的研究中进一步评估。
更新日期:2019-09-18
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