Autologous Hematopoietic Cell Transplant As an Effective Treatment Modality for Systemic Sclerosis and Multiple Myeloma

Overview

Journal J Blood Med

Publisher Dove Medical Press

Date 2025 Jan 13

PMID 39802914

Authors

Hamda Memon

Ricardo Parrondo

Julianna Schreurs

Ernesto Ayala

Madiha Iqbal

Affiliations

Soon will be listed here.

Abstract

Systemic sclerosis (SSc) is a multi-system disease characterized by a dysregulated immune system. Autologous hematopoietic cell transplantation (AHCT) is the only treatment that has been shown to confer significant benefit in controlling disease and improving survival for patients with SSc. A diagnosis of multiple myeloma (MM) after the diagnosis of SSc is rare and optimal treatment in such cases remains unclear. We here report a case of a female patient who was diagnosed with MM while she was undergoing evaluation for AHCT due to SSc. A novel conditioning regimen for AHCT, with therapeutic efficacy in SSc and MM was offered to the patient, resulting in long term remission of both diseases.

References

Bachleitner-Hofmann T, Machold K, Knobler R, Drach J, Grumbeck E, Gisslinger H . Marked and sustained improvement of systemic sclerosis following polychemotherapy for coexistent multiple myeloma. Clin Exp Rheumatol. 2002; 20(1):85-8. View

Wang L, Wang F, Gershwin M . Human autoimmune diseases: a comprehensive update. J Intern Med. 2015; 278(4):369-95. DOI: 10.1111/joim.12395. View

van Laar J, Farge D, Sont J, Naraghi K, Marjanovic Z, Larghero J . Autologous hematopoietic stem cell transplantation vs intravenous pulse cyclophosphamide in diffuse cutaneous systemic sclerosis: a randomized clinical trial. JAMA. 2014; 311(24):2490-8. DOI: 10.1001/jama.2014.6368. View

Kang Y, Zhang C, He Y, Zhang Z, Liu H, Wei Z . Thalidomide Attenuates Skin Lesions and Inflammation in Rosacea-Like Mice Induced by Long-Term Exposure of LL-37. Drug Des Devel Ther. 2022; 16:4127-4138. PMC: 9724583. DOI: 10.2147/DDDT.S393122. View

Moreau P, Facon T, Attal M, Hulin C, Michallet M, Maloisel F . Comparison of 200 mg/m(2) melphalan and 8 Gy total body irradiation plus 140 mg/m(2) melphalan as conditioning regimens for peripheral blood stem cell transplantation in patients with newly diagnosed multiple myeloma: final analysis of the.... Blood. 2002; 99(3):731-5. DOI: 10.1182/blood.v99.3.731. View

Shouval R, Furie N, Raanani P, Nagler A, Gafter-Gvili A . Autologous Hematopoietic Stem Cell Transplantation for Systemic Sclerosis: A Systematic Review and Meta-Analysis. Biol Blood Marrow Transplant. 2018; 24(5):937-944. DOI: 10.1016/j.bbmt.2018.01.020. View

Bruni C, Furst D . The burning question: To use or not to use cyclophosphamide in systemic sclerosis. Eur J Rheumatol. 2020; 7(Suppl 3):S237-S241. PMC: 7647679. DOI: 10.5152/eurjrheum.2020.19104. View

Attal M, Lauwers-Cances V, Hulin C, Leleu X, Caillot D, Escoffre M . Lenalidomide, Bortezomib, and Dexamethasone with Transplantation for Myeloma. N Engl J Med. 2017; 376(14):1311-1320. PMC: 6201242. DOI: 10.1056/NEJMoa1611750. View

Gabrielli A, Avvedimento E, Krieg T . Scleroderma. N Engl J Med. 2009; 360(19):1989-2003. DOI: 10.1056/NEJMra0806188. View

10.

Kowal-Bielecka O, Fransen J, Avouac J, Becker M, Kulak A, Allanore Y . Update of EULAR recommendations for the treatment of systemic sclerosis. Ann Rheum Dis. 2016; 76(8):1327-1339. DOI: 10.1136/annrheumdis-2016-209909. View

11.

Hodak E, Tamir R, David M, Hart M, SANDBANK M, Pick A . Scleredema adultorum associated with IgG-kappa multiple myeloma--a case report and review of the literature. Clin Exp Dermatol. 1988; 13(4):271-4. DOI: 10.1111/j.1365-2230.1988.tb00699.x. View

12.

Kazandjian D . Multiple myeloma epidemiology and survival: A unique malignancy. Semin Oncol. 2017; 43(6):676-681. PMC: 5283695. DOI: 10.1053/j.seminoncol.2016.11.004. View

13.

Sullivan K, Goldmuntz E, Keyes-Elstein L, McSweeney P, Pinckney A, Welch B . Myeloablative Autologous Stem-Cell Transplantation for Severe Scleroderma. N Engl J Med. 2018; 378(1):35-47. PMC: 5846574. DOI: 10.1056/nejmoa1703327. View

14.

Mayes M, Lacey Jr J, Beebe-Dimmer J, Gillespie B, Cooper B, Laing T . Prevalence, incidence, survival, and disease characteristics of systemic sclerosis in a large US population. Arthritis Rheum. 2003; 48(8):2246-55. DOI: 10.1002/art.11073. View

15.

Gajendra S, Gupta R, Gupta R, Kumar L . Coexistence of scleroderma with multiple myeloma: a rare association. BMJ Case Rep. 2013; 2013. PMC: 3794227. DOI: 10.1136/bcr-2013-200639. View

16.

Denton C, Khanna D . Systemic sclerosis. Lancet. 2017; 390(10103):1685-1699. DOI: 10.1016/S0140-6736(17)30933-9. View

17.

Basu A, Kundu S, Rahman M, Ray Y, Goswami R . Scleroderma-like Initial Presentation of Multiple Myeloma. J Assoc Physicians India. 2019; 65(12):93-95. View

18.

Tyndall A, Saccardi R . Haematopoietic stem cell transplantation in the treatment of severe autoimmune disease: results from phase I/II studies, prospective randomized trials and future directions. Clin Exp Immunol. 2005; 141(1):1-9. PMC: 1809422. DOI: 10.1111/j.1365-2249.2005.02806.x. View

19.

Riley D, Barber M, Kienle G, Aronson J, von Schoen-Angerer T, Tugwell P . CARE guidelines for case reports: explanation and elaboration document. J Clin Epidemiol. 2017; 89:218-235. DOI: 10.1016/j.jclinepi.2017.04.026. View

20.

Pattanaik D, Brown M, Postlethwaite B, Postlethwaite A . Pathogenesis of Systemic Sclerosis. Front Immunol. 2015; 6:272. PMC: 4459100. DOI: 10.3389/fimmu.2015.00272. View