The Korean Journal of Medicine

The Korean Association of Internal Medicine (대한내과학회)
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Autoimmune Diseases after Autologous Hematopoietic Stem Cell Transplantation in Patients with Non-Hodgkin's Lymphoma

비호지킨림프종 환자에서 자가조혈모세포이식 후 발생한 자가면역질환

  • Lee, Min-Young (Division of Hematology and Oncology, Department of Internal Medicine, Soonchunhyang University College of Medicine) ;
  • Yu, Shi Nae (Division of Hematology and Oncology, Department of Internal Medicine, Soonchunhyang University College of Medicine) ;
  • Kim, Kyoung Ha (Division of Hematology and Oncology, Department of Internal Medicine, Soonchunhyang University College of Medicine) ;
  • Lee, Sang-Cheol (Division of Hematology and Oncology, Department of Internal Medicine, Soonchunhyang University College of Medicine) ;
  • Lee, Nam Su (Division of Hematology and Oncology, Department of Internal Medicine, Soonchunhyang University College of Medicine) ;
  • Park, Hee Sook (Division of Hematology and Oncology, Department of Internal Medicine, Soonchunhyang University College of Medicine) ;
  • Won, Jong Ho (Division of Hematology and Oncology, Department of Internal Medicine, Soonchunhyang University College of Medicine)
  • 이민영 (순천향대학교 의과대학 내과학교실 종양혈액내과) ;
  • 유시내 (순천향대학교 의과대학 내과학교실 종양혈액내과) ;
  • 김경하 (순천향대학교 의과대학 내과학교실 종양혈액내과) ;
  • 이상철 (순천향대학교 의과대학 내과학교실 종양혈액내과) ;
  • 이남수 (순천향대학교 의과대학 내과학교실 종양혈액내과) ;
  • 박희숙 (순천향대학교 의과대학 내과학교실 종양혈액내과) ;
  • 원종호 (순천향대학교 의과대학 내과학교실 종양혈액내과)
  • Received : 2012.11.21
  • Accepted : 2013.03.04
  • Published : 2013.10.01
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Abstract

Autologous hematopoietic stem cell transplantation (HSCT) is an effective treatment for patients with relapsed or high-risk Non-Hodgkin's lymphoma (NHL). HSCT fundamentally interferes with the immune system. As a consequence, development of autoimmunity after HSCT has been observed during the past several decades. Most evidence is derived from single case reports or studies on small series of patients who developed novel-onset autoimmune diseases after use of HSCT to treat various conditions. We treated 3 NHL patients with autoimmune disease among 54 NHL patients who received high-dose chemotherapy and autologous HSCT.

자가조혈모세포이식은 재발성 또는 고위험군의 비호지킨림프종 환자에게 효과적인 치료방법이지만 기본적으로 면역 체계를 방해한다. 이에 따라 지난 수년간 자가조혈모세포이식 후의 자가면역체계에 대한 관찰이 이루어졌고 다양한 질환에서 자가조혈모세포이식 후에 새롭게 발생한 자가면역질환 환자들의 하나 혹은 여러 개의 사례가 보고되었다. 저자들은 비호지킨림프종으로 진단받아 고용량 항암화학치료와 자가조혈모세포이식을 받은 54명의 환자들 중에서 자가면역질환이 나타났던 3명의 환자에 대해 보고하는 바이다.

Keywords

References

  1. Milpied N, Deconinck E, Gaillard F, et al. Initial treatment of aggressive lymphoma with high-dose chemotherapy and autologous stem-cell support. N Engl J Med 2004;350:1287-1295. https://doi.org/10.1056/NEJMoa031770
  2. Bohgaki T, Atsumi T, Koike T. Autoimmune disease after autologous hematopoietic stem cell transplantation. Autoimmun Rev 2008;7:198-203. https://doi.org/10.1016/j.autrev.2007.11.005
  3. Loh Y, Oyama Y, Statkute L, et al. Development of a secondary autoimmune disorder after hematopoietic stem cell transplantation for autoimmune diseases: role of conditioning regimen used. Blood 2007;109:2643-2548. https://doi.org/10.1182/blood-2006-07-035766
  4. Bohgaki T, Atsumi T, Koike T. Multiple autoimmune diseases after autologous stem-cell transplantation. N Engl J Med 2007;357:2734-2736. https://doi.org/10.1056/NEJMc076383
  5. Daikeler T, Tyndall A. Autoimmunity following haematopoietic stem-cell transplantation. Best Pract Res Clin Haematol 2007;20:349-360. https://doi.org/10.1016/j.beha.2006.09.008
  6. 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 European Group for Blood and Marrow Transplantation Working Party on Autoimmune Diseases. Haematologica 2010;95:284-292. https://doi.org/10.3324/haematol.2009.013458
  7. King C, Ilic A, Koelsch K, Sarvetnick N. Homeostatic expansion of T cells during immune insufficiency generates autoimmunity. Cell 2004;117:265-277. https://doi.org/10.1016/S0092-8674(04)00335-6
  8. Koch B, Kranzhöfer N, Pfreundschu M, Pees HW, Trümper L. First manifestations of seronegative spondylarthropathy following autologous stem cell transplantation in HLAB27- positive patients. Bone Marrow Transplant 2000;26: 673-675. https://doi.org/10.1038/sj.bmt.1702565
  9. Hequet O, Salles G, Ketterer N, et al. Autoimmune thrombocytopenic purpura after autologous stem cell transplantation. Bone Marrow Transplant 2003;32:89-95. https://doi.org/10.1038/sj.bmt.1704073
  10. Daikeler T, Labopin M, Di Gioia M, et al. Secondary autoimmune diseases occurring after HSCT for an autoimmune disease: a retrospective study of the EBMT Autoimmune Disease Working Party. Blood 2011;118: 1693-1698. https://doi.org/10.1182/blood-2011-02-336156