Evolution, trends, outcomes, and economics of hematopoietic stem cell transplantation in severe autoimmune diseases by John A. Snowden, Manuela Badoglio,

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Presentation transcript:

Evolution, trends, outcomes, and economics of hematopoietic stem cell transplantation in severe autoimmune diseases by John A. Snowden, Manuela Badoglio, Myriam Labopin, Sebastian Giebel, Eoin McGrath, Zora Marjanovic, Joachim Burman, John Moore, Montserrat Rovira, Nico M. Wulffraat, Majid Kazmi, Raffaella Greco, Emilian Snarski, Tomas Kozak, Kirill Kirgizov, Tobias Alexander, Peter Bader, Riccardo Saccardi, and Dominique Farge BloodAdv Volume 1(27):2742-2755 December 26, 2017 © 2017 by The American Society of Hematology

John A. Snowden et al. Blood Adv 2017;1:2742-2755 © 2017 by The American Society of Hematology

Trends in activity for HSCT in autoimmune diseases. Trends in activity for HSCT in autoimmune diseases. (A) By autologous and allogeneic HSCT and (B) by indication. IDD, insulin-dependent diabetes. John A. Snowden et al. Blood Adv 2017;1:2742-2755 © 2017 by The American Society of Hematology

Trends in activity of autologous HSCT Trends in activity of autologous HSCT. (A) MS overall, (B) ratio of relapsing remitting (RR)–MS to progressive MS, (C) systemic sclerosis, (D) Crohn disease, (E) SLE, and (F) inflammatory arthritis. Trends in activity of autologous HSCT. (A) MS overall, (B) ratio of relapsing remitting (RR)–MS to progressive MS, (C) systemic sclerosis, (D) Crohn disease, (E) SLE, and (F) inflammatory arthritis. John A. Snowden et al. Blood Adv 2017;1:2742-2755 © 2017 by The American Society of Hematology

Trends in activity of autologous HSCT Trends in activity of autologous HSCT. (A) MS overall, (B) ratio of relapsing remitting (RR)–MS to progressive MS, (C) systemic sclerosis, (D) Crohn disease, (E) SLE, and (F) inflammatory arthritis. Trends in activity of autologous HSCT. (A) MS overall, (B) ratio of relapsing remitting (RR)–MS to progressive MS, (C) systemic sclerosis, (D) Crohn disease, (E) SLE, and (F) inflammatory arthritis. John A. Snowden et al. Blood Adv 2017;1:2742-2755 © 2017 by The American Society of Hematology

Trends in the activity of HSCT in AD by nation. Trends in the activity of HSCT in AD by nation. (A) Overall with relative disease-specific contributions. (B) Activity per head of population. John A. Snowden et al. Blood Adv 2017;1:2742-2755 © 2017 by The American Society of Hematology

Epoch analysis of trends in incidence of relapse/progression, NRM, and PFS from 1995 to 1999, 2000 to 2004, 2005 to 2010, and 2011 to 2015 (all indications). Epoch analysis of trends in incidence of relapse/progression, NRM, and PFS from 1995 to 1999, 2000 to 2004, 2005 to 2010, and 2011 to 2015 (all indications). Data for 100-day NRM and 3-year NRM, RI, PFS, and OS, respectively, were: 1994-1999: 6.4%, 7.1%, 52.2%, 40.6%, and 87%; 2000-2004: 3.7%, 5.6%, 39.3%, 55.1%, and 88.4%; 2005-2010: 3.2%, 4.9%, 32.2% 62.9%, and 89.6%; and 2011-2015: 1.3%, 3%, 34.2% 62.8%, and 90.3%. CI, confidence interval. John A. Snowden et al. Blood Adv 2017;1:2742-2755 © 2017 by The American Society of Hematology

Long-term OS, PFS, cumulative relapse incidence, and NRM following first autologous HSCT in MS, SSc, and CD. Data for 100-day NRM and 3-year NRM, RI, PFS, and OS for each disease were as follows: MS, 1.1% (95% CI, 0.5-2.1) and 1.5% (95% CI, 0.8-2.7), 34.4% (95% CI, 30.1-38.8), 64% (95% CI, 59.6-68.5), and 95.5% (95% CI, 0.80-2.7); SSc, 5% (95% CI, 3.7-7.7), 7.2% (95% CI, 4.7-10.4), 31.1% (95% CI, 25.5-36.7), 61.8% (95% CI, 55.9-67.6), and 80.3% (95% CI, 75.8-84.8); CD, 0.9% (95% CI, 0.1-4.7), 0.9% (95% CI, 0.1-4.7), 60.4% (95% CI, 47.7-70.9), 38.7% (95% CI, 27.2-50.1), and 96.7% (95% CI, 93-100). Long-term OS, PFS, cumulative relapse incidence, and NRM following first autologous HSCT in MS, SSc, and CD. Data for 100-day NRM and 3-year NRM, RI, PFS, and OS for each disease were as follows: MS, 1.1% (95% CI, 0.5-2.1) and 1.5% (95% CI, 0.8-2.7), 34.4% (95% CI, 30.1-38.8), 64% (95% CI, 59.6-68.5), and 95.5% (95% CI, 0.80-2.7); SSc, 5% (95% CI, 3.7-7.7), 7.2% (95% CI, 4.7-10.4), 31.1% (95% CI, 25.5-36.7), 61.8% (95% CI, 55.9-67.6), and 80.3% (95% CI, 75.8-84.8); CD, 0.9% (95% CI, 0.1-4.7), 0.9% (95% CI, 0.1-4.7), 60.4% (95% CI, 47.7-70.9), 38.7% (95% CI, 27.2-50.1), and 96.7% (95% CI, 93-100). John A. Snowden et al. Blood Adv 2017;1:2742-2755 © 2017 by The American Society of Hematology