mrjСовременная ревматологияModern Rheumatology Journal1996-70122310-158XIMA-PRESS, LLC10.14412/1996-7012-2021-1-66-72mrj-1102Research ArticleОБЗОРЫREVIEWSТрансплантация аутологичных гемопоэтических стволовых клеток в лечении системной склеродермии. Часть 2. Безопасность и осложненияAutologous hematopoietic stem cell transplantation in the treatment of systemic sclerosis. Part 2. Safety and complicationshttps://orcid.org/0000-0003-2667-4284ОвсянниковаО. Б.OvsyannikovaO. B.

Ольга Борисовна Овсянникова

115522, Москва, Каширское шоссе, 34А

 

Olga Borisovna Ovsyannikovna

1/2, Barrikadnaya St., Build. 1, Moscow 125993

sorry_84@mail.ruhttps://orcid.org/0000-0002-3248-6426АнаньеваЛ. П.AnanyevaL. P.

115522, Москва, Каширское шоссе, 34А

1/2, Barrikadnaya St., Build. 1, Moscow 125993

https://orcid.org/0000-0003-3650-7658КоневаО. А.KonevaO. A.

115522, Москва, Каширское шоссе, 34А

1/2, Barrikadnaya St., Build. 1, Moscow 125993

https://orcid.org/0000-0002-5012-0540ГарзановаЛ. А.GarzanovaL. A.

115522, Москва, Каширское шоссе, 34А

1/2, Barrikadnaya St., Build. 1, Moscow 125993

https://orcid.org/0000-0002-0283-9681ДесиноваО. В.DesinovaO. V.

115522, Москва, Каширское шоссе, 34А

1/2, Barrikadnaya St., Build. 1, Moscow 125993

https://orcid.org/0000-0003-4688-9637ШаяхметоваР. У.ShayakhmetovaR. U.

115522, Москва, Каширское шоссе, 34А

1/2, Barrikadnaya St., Build. 1, Moscow 125993

https://orcid.org/0000-0002-1004-9647СтаровойтоваМ. Н.StarovoitovaM. N.

115522, Москва, Каширское шоссе, 34А

1/2, Barrikadnaya St., Build. 1, Moscow 125993

https://orcid.org/0000-0002-6068-3080ЛилаА. М.LilaA. M.

Кафедра ревматологии ФГБОУ ДПО «Российская медицинская академия непрерывного профессионального образования» Минздрава России

115522, Москва, Каширское шоссе, 34А,

125993, Москва, ул. Баррикадная, 2/1, стр. 1

Department of Rheumatology Russian Medical Academy of Continuing Professional Education

34A, Kashirskoe Shosse, Moscow 115522,

1/2, Barrikadnaya St., Build. 1, Moscow 125993

ФГБНУ «Научно-исследовательский институт ревматологии им. В.А. Насоновой»РоссияV.A. Nasonova Research Institute of RheumatologyRussian FederationФГБНУ «Научно-исследовательский институт ревматологии им. В.А. Насоновой»РоссияV.A. Nasonova Research Institute of RheumatologyV.A. Nasonova Research Institute of RheumatologyRussian FederationФГБНУ «Научно-исследовательский институт ревматологии им. В.А. Насоновой»; ФГБОУ ДПО «Российская медицинская академия непрерывного профессионального образования» Минздрава РоссииРоссияV.A. Nasonova Research Institute of Rheumatology; Russian Medical Academy of Continuing Professional EducationRussian Federation2021180220211516672Copyright © Овсянникова О.Б., Ананьева Л.П., Конева О.А., Гарзанова Л.А., Десинова О.В., Шаяхметова Р.У., Старовойтова М.Н., Лила А.М., 20212021Овсянникова О.Б., Ананьева Л.П., Конева О.А., Гарзанова Л.А., Десинова О.В., Шаяхметова Р.У., Старовойтова М.Н., Лила А.М.Ovsyannikova O.B., Ananyeva L.P., Koneva O.A., Garzanova L.A., Desinova O.V., Shayakhmetova R.U., Starovoitova M.N., Lila A.M.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://mrj.ima-press.net/mrj/article/view/1102

В настоящее время аутотрансплантация гемопоэтических стволовых клеток (аутоТГСК) – единственная болезнь-модифицирующая стратегия лечения системной склеродермии (ССД), имеющая уровень доказательности А, эффективность которой была доказана в трех контролируемых клинических исследованиях – ASSIST, ASTIS, SCOT. Несмотря на позитивные результаты, полученные при использовании данного метода лечения, нерешенными остаются вопросы, связанные с его переносимостью и безопасностью. Осложнения, вызванные выраженной иммуносупрессией и увеличением частоты инфекций, являются главными причинами смерти после аутоТГСК при аутоиммунных заболеваниях и встречаются в основном в первый месяц после лечения. В целом проведенные исследования подтверждают общую оценку аутоТГСК как эффективного и относительно безопасного метода терапии тяжелой формы ССД.

Autologous hematopoietic stem cell transplantation (auto-HSCT) is presently the only disease-modifying strategy for the treatment of systemic sclerosis (SSs) that has Level A evidence, the effectiveness of which has been proven in three controlled clinical trials: ASSIST, ASTIS, and SCOT. Despite the positive results obtained with the use of this treatment option, the issues related to its tolerability and safety remain unresolved. The complications caused by obvious immunosuppression and higher frequency of infections are the main causes of death after autoHSCT for autoimmune diseases and occur mainly in the first month after treatment. Overall, the studies performed confirm the overall assessment of auto-HSCT as an effective and relatively safe treatment for severe SSs.

системная склеродермияаутотрасплантациягемопоэтические стволовые клеткиосложненияпобочные эффектыsystemic sclerosisautotransplantationhematopoietic stem cellscomplicationstransplantationside effectsReferencesГусева НГ. Системная склеродермия и псеводсклеродермические синдромы. Москва: Медицина; 1993. 267 с.Guseva NG. Sistemnaya sklerodermiya i psevodsklerodermicheskie sindromy [Systemic scleroderma and pseudoscleroderma syndromes]. Moscow: Meditsina; 1993. 267 p.Steen VD, Medsger TA. Changes in causes of death in systemic sclerosis, 1972-2002. Ann Rheum Dis. 2007 Jul;66(7):940-4. doi: 10.1136/ard.2006.066068. Epub 2007 Feb 28.Steen VD, Medsger TA. Changes in causes of death in systemic sclerosis, 1972-2002. Ann Rheum Dis. 2007 Jul;66(7):940-4. doi: 10.1136/ard.2006.066068. Epub 2007 Feb 28.Fuschiotti P. Current perspectives on the immunopathogenensis of systemic sclerosis. Immunotargets Ther. 2016 Apr 11;5:21-35. doi: 10.2147/ITT.S82037. eCollection 2016.Fuschiotti P. Current perspectives on the immunopathogenensis of systemic sclerosis. Immunotargets Ther. 2016 Apr 11;5:21-35. doi: 10.2147/ITT.S82037. eCollection 2016.Kowal-Bielecka O, Fransen J, Avouac J, et al. Update of EULAR recommendations for the treatment of systemic sclerosis. Ann Rheum Dis. 2017 Aug;76(8):1327-1339. doi:10.1136/annrheumdis-2016-209909. Epub 2016 Nov 9.Kowal-Bielecka O, Fransen J, Avouac J, et al. Update of EULAR recommendations for the treatment of systemic sclerosis. Ann Rheum Dis. 2017 Aug;76(8):1327-1339. doi:10.1136/annrheumdis-2016-209909. Epub 2016 Nov 9.Denton CP, Hughes M, Gak N, et al. BSR and GHPR guideline for the treatment of systemic sclerosis. Rheumatology (Oxford). 2016 Oct;55(10):1906-10. doi:10.1093/rheumatology/kew224. Epub 2016 Jun 9.Denton CP, Hughes M, Gak N, et al. BSR and GHPR guideline for the treatment of systemic sclerosis. Rheumatology (Oxford). 2016 Oct;55(10):1906-10. doi:10.1093/rheumatology/kew224. Epub 2016 Jun 9.Steen VD, Medsger TA Jr. Severe organ involvement in systemic sclerosis with diffuse scleroderma. Arthritis Rheum. 2000 Nov; 43(11):2437-44. doi: 10.1002/1529-0131(200011)43:113.0.CO;2-U.Steen VD, Medsger TA Jr. Severe organ involvement in systemic sclerosis with diffuse scleroderma. Arthritis Rheum. 2000 Nov; 43(11):2437-44. doi: 10.1002/1529-0131(200011)43:113.0.CO;2-U.Fransen J, Popa-Diaconu D, Hesselstrand R, et al. Clinical prediction of 5-year survival in systemic sclerosis: validation of simple prognostic model in EUSTAR centres. Ann Rheum Dis. 2011 Oct;70(10):1788-92. doi:10.1136/ard.2010.144360. Epub 2011 Jul 21.Fransen J, Popa-Diaconu D, Hesselstrand R, et al. Clinical prediction of 5-year survival in systemic sclerosis: validation of simple prognostic model in EUSTAR centres. Ann Rheum Dis. 2011 Oct;70(10):1788-92. doi:10.1136/ard.2010.144360. Epub 2011 Jul 21.Kelsey PJ, Oliveira MC, Badoglio M, et al. Haemopoietic stem cell transplantation in autoimmune disease: from basic science to clinical practice. Curr Res Transl Med. Apr-Jun 2016;64(2):71-82. doi:10.1016/j.retram.2016.03.003. Epub 2016 May 31.Kelsey PJ, Oliveira MC, Badoglio M, et al. Haemopoietic stem cell transplantation in autoimmune disease: from basic science to clinical practice. Curr Res Transl Med. Apr-Jun 2016;64(2):71-82. doi:10.1016/j.retram.2016.03.003. Epub 2016 May 31.Van Laar JM, Farge D, Sont JK, et al. Autologous haemopoetic stem cell transplantation vs intravenous pulse cyclophosphamide in diffuse cutaneous systemic sclerosis: a randomized clinical trial. JAMA. 2014 Jun 25;311(24):2490-8. doi: 10.1001/jama.2014.6368.Van Laar JM, Farge D, Sont JK, et al. Autologous haemopoetic stem cell transplantation vs intravenous pulse cyclophosphamide in diffuse cutaneous systemic sclerosis: a randomized clinical trial. JAMA. 2014 Jun 25;311(24):2490-8. doi: 10.1001/jama.2014.6368.Burt RK, Shah SJ, Dill K, et al. Autologous non-myeloablative hemotopoetic stem-cell transplantation compared with pulse cyclophosphamide once per months for systemic sclerosis (ASSIST): an open label. Randomized phase 2 trial. Lancet. 2011 Aug 6;378(9790):498-506. doi: 10.1016/S0140-6736(11)60982-3. Epub 2011 Jul 21.Burt RK, Shah SJ, Dill K, et al. Autologous non-myeloablative hemotopoetic stem-cell transplantation compared with pulse cyclophosphamide once per months for systemic sclerosis (ASSIST): an open label. Randomized phase 2 trial. Lancet. 2011 Aug 6;378(9790):498-506. doi: 10.1016/S0140-6736(11)60982-3. Epub 2011 Jul 21.Sullivan KM, Goldmuntz EA, KeyesElstein L, et al. Myeloablative autologous stem-cell transplantation for severe scleroderma. N Engl JMed. 2018 Jan 4;378(1):35-47. doi: 10.1056/nejmoa1703327.Sullivan KM, Goldmuntz EA, KeyesElstein L, et al. Myeloablative autologous stem-cell transplantation for severe scleroderma. N Engl JMed. 2018 Jan 4;378(1):35-47. doi: 10.1056/nejmoa1703327.Farge D, Labopin M, Tyndall A, et al. Autologous hematopoietic stem cell transplantation for autoimmune diseases: an observational study on 12 years’ experience from the Europen Group for Blood and Marrow Transplantation Working Party on Autoimmune Diseases. Haemotologica. 2010 Feb;95(2):284-92. doi: 10.3324/haematol.2009.013458. Epub 2009 Sep 22.Farge D, Labopin M, Tyndall A, et al. Autologous hematopoietic stem cell transplantation for autoimmune diseases: an observational study on 12 years’ experience from the Europen Group for Blood and Marrow Transplantation Working Party on Autoimmune Diseases. Haemotologica. 2010 Feb;95(2):284-92. doi: 10.3324/haematol.2009.013458. Epub 2009 Sep 22.Snowden JA, Badoglio M, Labopin M, et al. Evolution, trends, outcomes, and economics of hematopoietic stem cell transplantation in severe autoimmune diseases. Blood Adv. 2017 Dec 20;1(27):2742-2755. doi: 10.1182/bloodadvances.2017010041. eCollection 2017 Dec 26.Snowden JA, Badoglio M, Labopin M, et al. Evolution, trends, outcomes, and economics of hematopoietic stem cell transplantation in severe autoimmune diseases. Blood Adv. 2017 Dec 20;1(27):2742-2755. doi: 10.1182/bloodadvances.2017010041. eCollection 2017 Dec 26.Domsic RT, Rodriguez-Reyna T, Lucas M, et al. Skin thickness progression rate: a predictor of mortality and early internal organ involvement in diffuse scleroderma. Ann Rheum Dis. 2011 Jan;70(1):104-9. doi:10.1136/ard.2009.127621. Epub 2010 Aug 2.Domsic RT, Rodriguez-Reyna T, Lucas M, et al. Skin thickness progression rate: a predictor of mortality and early internal organ involvement in diffuse scleroderma. Ann Rheum Dis. 2011 Jan;70(1):104-9. doi:10.1136/ard.2009.127621. Epub 2010 Aug 2.Maurer B, Graf N, Michal BA, et al. Prediction of worsening of skin fibrosis in patients with diffuse cutaneous systemic sclerosis using the EUSTAR database. Ann Rheum Dis. 2015 Jun;74(6):1124-31. doi: 10.1136/annrheumdis-2014-205226. Epub 2014 Jun 30.Maurer B, Graf N, Michal BA, et al. Prediction of worsening of skin fibrosis in patients with diffuse cutaneous systemic sclerosis using the EUSTAR database. Ann Rheum Dis. 2015 Jun;74(6):1124-31. doi: 10.1136/annrheumdis-2014-205226. Epub 2014 Jun 30.Steen VD, Medsger TA Jr. Improvement in skin thickening in systemic sclerosis associated with improved survival. Arthritis Rheum. 2001 Dec;44(12):2828-35. doi:10.1002/1529-0131(200112)44:123.0.co;2-u.Steen VD, Medsger TA Jr. Improvement in skin thickening in systemic sclerosis associated with improved survival. Arthritis Rheum. 2001 Dec;44(12):2828-35. doi:10.1002/1529-0131(200112)44:123.0.co;2-u.Del Papa N, Onida F, Zaccara E, et al. Autologous hematopoietic stem cell transplantation has better outcomes than conventional therapies in patients with rabidly progressive systemic sclerosis. Bone Marrow Transplant. 2017 Jan;52(1):53-8. doi: 10.1038/bmt.2016.211. Epub 2016 Aug 22.Del Papa N, Onida F, Zaccara E, et al. Autologous hematopoietic stem cell transplantation has better outcomes than conventional therapies in patients with rabidly progressive systemic sclerosis. Bone Marrow Transplant. 2017 Jan;52(1):53-8. doi: 10.1038/bmt.2016.211. Epub 2016 Aug 22.Гарзанова ЛА, Ананьева ЛП, Конева ОА, Овсянникова ОБ. Влияние ритуксимаба на поражение сердца при системной склеродермии. Научно-практическая ревматология. 2018;56(6):709-15.Garzanova LA, Ananyeva LP, Koneva OA, Ovsyannikova OB. Effect of rituximab on heart involvement in systemic sclerosis. Nauchno-Prakticheskaya Revmatologiya. 2018;56(6):709-15. (In Russ.).Farge D, Burt RK, Oliveire MC, et al. Cardiopulmonary assessment of patients with systemic sclerosis for hematopoietic stem cell transplantation: recommendations from the European Society for Blood and Marrow Transplantation Autoimmune Disease Working Party and collaborating partners. Bone Marrow Transplantation. 2017 Nov; 52(11):1495-503. doi: 10.1038/bmt.2017.56. Epub 2017 May 22.Farge D, Burt RK, Oliveire MC, et al. Cardiopulmonary assessment of patients with systemic sclerosis for hematopoietic stem cell transplantation: recommendations from the European Society for Blood and Marrow Transplantation Autoimmune Disease Working Party and collaborating partners. Bone Marrow Transplantation. 2017 Nov; 52(11):1495-503. doi: 10.1038/bmt.2017.56. Epub 2017 May 22.Daikeler T, Tichelli A, Passweg J. Complications of autologous hematopoietic stem cell transplantation for patients with autoimmune disease. Pediatr Res. 2012 Apr; 71(4 Pt 2):439-44. doi: 10.1038/pr.2011.57. Epub 2012 Feb 8.Daikeler T, Tichelli A, Passweg J. Complications of autologous hematopoietic stem cell transplantation for patients with autoimmune disease. Pediatr Res. 2012 Apr; 71(4 Pt 2):439-44. doi: 10.1038/pr.2011.57. Epub 2012 Feb 8.Storek J, Zhao Z, Lin E, et al. Recovery from and consequences of severe iatrogenic lymphopenia (induced to treat autoimmune diseases). Clin Immunol. 2004 Dec; 113 (3): 285-98. doi: 10.1076/j.clim.2004.07.006.Storek J, Zhao Z, Lin E, et al. Recovery from and consequences of severe iatrogenic lymphopenia (induced to treat autoimmune diseases). Clin Immunol. 2004 Dec; 113 (3): 285-98. doi: 10.1076/j.clim.2004.07.006.Maciejawska M, Snarski E, WiktorJedrzejczak W. A preliminary online study on menstruation recovery in women after autologous hemotopoietic stem cell transplant for autoimmune diseases. Exp Clin Transplant. 2016 Dec;14(6):665-9. doi: 10.6002/ect.2015.0336. Epub 2016 Jun 15.Maciejawska M, Snarski E, WiktorJedrzejczak W. A preliminary online study on menstruation recovery in women after autologous hemotopoietic stem cell transplant for autoimmune diseases. Exp Clin Transplant. 2016 Dec;14(6):665-9. doi: 10.6002/ect.2015.0336. Epub 2016 Jun 15.Snarski E, Snowden JA, Oliveria MC, et al. Onset and outcome of pregnancy after autologous haematopoietic SCT (AHSCT) for autoimmune diseases: a retrospective study of the EBMT autoimmune diseases working party (ADWP). Bone Marrow Transplant. 2015 Feb; 50(2):216-20. doi: 10.1038/bmt.2014.248. Epub 2014 Nov 10.Snarski E, Snowden JA, Oliveria MC, et al. Onset and outcome of pregnancy after autologous haematopoietic SCT (AHSCT) for autoimmune diseases: a retrospective study of the EBMT autoimmune diseases working party (ADWP). Bone Marrow Transplant. 2015 Feb; 50(2):216-20. doi: 10.1038/bmt.2014.248. Epub 2014 Nov 10.Brown JR, Yeckes H, Friedberg JW, et al. Increasing incidence for late second malignancies after conditioning with cyclophosphamide and total-body irradiation and autologous bone marrow transplantation for non – Hodgkin’s lymphoma. J Clin Oncol. 2005 Apr 1;23(10):2208-14. doi: 10.1200/JCO.2005.05.158. Epub 2005 Mar 7.Brown JR, Yeckes H, Friedberg JW, et al. Increasing incidence for late second malignancies after conditioning with cyclophosphamide and total-body irradiation and autologous bone marrow transplantation for non – Hodgkin’s lymphoma. J Clin Oncol. 2005 Apr 1;23(10):2208-14. doi: 10.1200/JCO.2005.05.158. Epub 2005 Mar 7.Armitage JO, Carbone PP, Connors JM, et al. Treatment-related myelodysplasia and acute leukemia in non-Hodgkin’s lymphoma patients. J Clin Oncol. 2003 Mar 1;21(5): 897-906. doi: 10.1200/JCO.2003.07.113Armitage JO, Carbone PP, Connors JM, et al. Treatment-related myelodysplasia and acute leukemia in non-Hodgkin’s lymphoma patients. J Clin Oncol. 2003 Mar 1;21(5): 897-906. doi: 10.1200/JCO.2003.07.113Vaxman J, Ram R, Gafler-Gvili A, et al. Secondary malignancies following high dose therapy and autologous hematopoietic cell transplantation-systematic review and metaanalysis. Bone Marrow Transplant. 2015 May; 50(5):706-14. doi: 10.1038/bmt.2014.325. Epub 2015 Feb 9.Vaxman J, Ram R, Gafler-Gvili A, et al. Secondary malignancies following high dose therapy and autologous hematopoietic cell transplantation-systematic review and metaanalysis. Bone Marrow Transplant. 2015 May; 50(5):706-14. doi: 10.1038/bmt.2014.325. Epub 2015 Feb 9.Bonifazi M, Tramacere I, Pomponio G, et al. Systemic sclerosis (scleroderma) and cancer risk: systemic review and meta-analysis of observational studies. Rheumatology (Oxford). 2013 Jan;52(1):143-54. doi: 10.1093/rheumatology/kes303. Epub 2012 Nov 22.Bonifazi M, Tramacere I, Pomponio G, et al. Systemic sclerosis (scleroderma) and cancer risk: systemic review and meta-analysis of observational studies. Rheumatology (Oxford). 2013 Jan;52(1):143-54. doi: 10.1093/rheumatology/kes303. Epub 2012 Nov 22.Onishi A, Sugiyama D, Kumagai S, et al. Cancer incidence in systemic sclerosis: metaanalysis of population-based cohort studies. Arthritis Rheum. 2013 Jul;65(7):1913-21. doi: 10.1002/art.37969.Onishi A, Sugiyama D, Kumagai S, et al. Cancer incidence in systemic sclerosis: metaanalysis of population-based cohort studies. Arthritis Rheum. 2013 Jul;65(7):1913-21. doi: 10.1002/art.37969.Zhang IQ, Wan YN, Peng WJ, et al. The risk of cancer development in systemic sclerosis: a meta-analysis. Cancer Epidemiol. 2013 Oct;37(5):523-7. doi: 10.1016/j.canep.2013.04.014. Epub 2013 May.Zhang IQ, Wan YN, Peng WJ, et al. The risk of cancer development in systemic sclerosis: a meta-analysis. Cancer Epidemiol. 2013 Oct;37(5):523-7. doi: 10.1016/j.canep.2013.04.014. Epub 2013 May.Daikeler T, Tyndall A. Autoimmunity following haematopoietic stem-cell transplantation. Best Pract Res Clin Haematol. 2007 Jun; 20(2):349-60. doi: 10.1016/j.beha.2006.09.008.Daikeler T, Tyndall A. Autoimmunity following haematopoietic stem-cell transplantation. Best Pract Res Clin Haematol. 2007 Jun; 20(2):349-60. doi: 10.1016/j.beha.2006.09.008.Daikeler T, Tichelli A, Passweg J. Complications of autologous hematopoietic stem cell transplantation for patients with autoimmune disease. Pediatr Res. 2012 Apr; 71(4 Pt 2):439-44. doi: 10.1038/pr.2011.57. Epub 2012 Feb 8.Daikeler T, Tichelli A, Passweg J. Complications of autologous hematopoietic stem cell transplantation for patients with autoimmune disease. Pediatr Res. 2012 Apr; 71(4 Pt 2):439-44. doi: 10.1038/pr.2011.57. Epub 2012 Feb 8.Daikeler T, Labopin M, Di Gioia M, et al. Secondary autoimmune disease occurring after HSCT for an autoimmune disease: a retrospective study of the EBMT Autoimmune Disease Working Party. Blood. 2011 Aug 11;118(6):1693-8. doi: 10.1182/blood-2011-02-336156. Epub 2011 May 19.Daikeler T, Labopin M, Di Gioia M, et al. Secondary autoimmune disease occurring after HSCT for an autoimmune disease: a retrospective study of the EBMT Autoimmune Disease Working Party. Blood. 2011 Aug 11;118(6):1693-8. doi: 10.1182/blood-2011-02-336156. Epub 2011 May 19.Nash RA, McSwenney PA, Crofford LJ, et al. High-dose immunosuppressive therapy and autologous hematopoietic cell transplantation for severe systemic sclerosis: long-term follow-up of the US multicenter pilot study. Blood. 2007 Aug 15;110(4):1388-96. doi: 10.1182/blood-2007-02-072389. Epub 2007 Apr 23.Nash RA, McSwenney PA, Crofford LJ, et al. High-dose immunosuppressive therapy and autologous hematopoietic cell transplantation for severe systemic sclerosis: long-term follow-up of the US multicenter pilot study. Blood. 2007 Aug 15;110(4):1388-96. doi: 10.1182/blood-2007-02-072389. Epub 2007 Apr 23.Henes JC, Schmalzing M, Vogel W, et al. Optimization of autologous stem cell transplantation for systemic sclerosis – a single – center longterm experience in 26 patients with severe organ manifestations. J Rheumatol. 2012 Feb;39(2):269-75. doi: 10.3899/jrheum.110868. Epub 2012 Jan 15.Henes JC, Schmalzing M, Vogel W, et al. Optimization of autologous stem cell transplantation for systemic sclerosis – a single – center longterm experience in 26 patients with severe organ manifestations. J Rheumatol. 2012 Feb;39(2):269-75. doi: 10.3899/jrheum.110868. Epub 2012 Jan 15.Burt RK, Oliveira MC, Shah SJ, et al. Cardiac involvement and treatment – related mortality after non-myeloablative haemopoietic stem-cell transplantation with unselected autologous peripheral blood for patients with systemic sclerosis: a retrospective analysis. Lancet. 2013 Mar 30;381(9872):1116-24. doi: 10.1016/S0140-6736(12)62114-X. Epub 2013 Jan 28.Burt RK, Oliveira MC, Shah SJ, et al. Cardiac involvement and treatment – related mortality after non-myeloablative haemopoietic stem-cell transplantation with unselected autologous peripheral blood for patients with systemic sclerosis: a retrospective analysis. Lancet. 2013 Mar 30;381(9872):1116-24. doi: 10.1016/S0140-6736(12)62114-X. Epub 2013 Jan 28.Morandi P, Ruffini PA, Benvenuto GM, et al. Cardiac toxicity of high-dose chemotherapy. Bone Marrow Transplant. 2005 Feb;35(4):323-34. doi: 10.1038/sj.bmt.1704763.Morandi P, Ruffini PA, Benvenuto GM, et al. Cardiac toxicity of high-dose chemotherapy. Bone Marrow Transplant. 2005 Feb;35(4):323-34. doi: 10.1038/sj.bmt.1704763.Shah SJ. Pulmonary hypertension. JAMA. 2012 Oct 3;308(13):1366-74. doi: 10.1001/jama.2012.12347.Shah SJ. Pulmonary hypertension. JAMA. 2012 Oct 3;308(13):1366-74. doi: 10.1001/jama.2012.12347.Krishnamurthy R, Cheong B, Muthupillai R. Tools for cardiovascular magnetic resonance imaging. Cardiovase Diagn Ther. 2014 Apr;4(2):104-25. doi: 10.3978/j.issn.2223-3652.2014.03.06.Krishnamurthy R, Cheong B, Muthupillai R. Tools for cardiovascular magnetic resonance imaging. Cardiovase Diagn Ther. 2014 Apr;4(2):104-25. doi: 10.3978/j.issn.2223-3652.2014.03.06.Mavrogeni SI, Schwitter J, Gargani L, et al. Cardiovasculare magnetic resonance in systemic sclerosis «Pearls and pitfalls». Semin Arthritis Rheum. 2017 Aug;47(1):79-85. doi: 10.1016/j.semarthrit.2017.03.020. Epub 2017 Mar 31.Mavrogeni SI, Schwitter J, Gargani L, et al. Cardiovasculare magnetic resonance in systemic sclerosis «Pearls and pitfalls». Semin Arthritis Rheum. 2017 Aug;47(1):79-85. doi: 10.1016/j.semarthrit.2017.03.020. Epub 2017 Mar 31.Ehlers SL, Gastineau DA, Patten CA, et al. The impact of smoking on outcomes among patients undergoing hematopoietic SCT for the treatment of acute leukemia. Bone Marrow Transplant. 2011 Feb;46(2): 285-90. doi: 10.1038/bmt.2010.113. Epub 2010 May 17.Ehlers SL, Gastineau DA, Patten CA, et al. The impact of smoking on outcomes among patients undergoing hematopoietic SCT for the treatment of acute leukemia. Bone Marrow Transplant. 2011 Feb;46(2): 285-90. doi: 10.1038/bmt.2010.113. Epub 2010 May 17.Zeidel A, Beilin B, Yardeni I, et al. Immune response in asymptomatic smokers. Acta Anaesthesiol Scand. 2002 Sep;46(8): 959-64. doi: 10.1038/j.1399-6576.2002.460806.x.Zeidel A, Beilin B, Yardeni I, et al. Immune response in asymptomatic smokers. Acta Anaesthesiol Scand. 2002 Sep;46(8): 959-64. doi: 10.1038/j.1399-6576.2002.460806.x.Steen VD, Owens GR, Fino GJ, et al. Pulmonary involvement in systemic sclerosis (scleroderma). Arthritis Rheum. 1985 Jul; 28(7):759-67. doi: 10.1002/art.1780280706.Steen VD, Owens GR, Fino GJ, et al. Pulmonary involvement in systemic sclerosis (scleroderma). Arthritis Rheum. 1985 Jul; 28(7):759-67. doi: 10.1002/art.1780280706.Quadrelli SA, Molinari L, Ciallella LM, et al. Patterns of pulmonary function in smoking and nonsmoking patients with progressive systemic sclerosis. Rheumatol Int. 2009 Jul;29(9):995-9. doi: 10.1007/s00296-008-0824-0. Epub 2009 Jan 8.Quadrelli SA, Molinari L, Ciallella LM, et al. Patterns of pulmonary function in smoking and nonsmoking patients with progressive systemic sclerosis. Rheumatol Int. 2009 Jul;29(9):995-9. doi: 10.1007/s00296-008-0824-0. Epub 2009 Jan 8.Helbig G, Widuchowska M, Koclega A, et al. Safety profile of autologous hematopoietic stem cell mobilization and transplantation in patients with systemic sclerosis. Clin Rheumatol. 2018 Jun;37(6):1709-14. doi: 10.1007/s10067-017-3954-5. Epub 2017 Dec 18.Helbig G, Widuchowska M, Koclega A, et al. Safety profile of autologous hematopoietic stem cell mobilization and transplantation in patients with systemic sclerosis. Clin Rheumatol. 2018 Jun;37(6):1709-14. doi: 10.1007/s10067-017-3954-5. Epub 2017 Dec 18.

The authors declare that there are no conflicts of interest present.