Life after Autologous Hematopoietic Stem Cell Transplantation for Systemic Sclerosis

Daniela A Moraes,1 Maria Carolina Oliveira2 1Division of Clinical Immunology, Department of Internal Medicine, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil; 2Center for Cell-Based Therapy, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, BrazilCorrespondence: Maria Carolina OliveiraDepartment of Internal Medicine, Ribeirão Preto Medical School, University of São Paulo, Avenida dos Bandeirantes, 3900, Ribeirão Preto, SP, 14048-900, BrazilEmail mcarolor@usp.brAbstract: Stem cell transplantation has been investigated as treatment for severe and progressive systemic sclerosis (SSc) for the past 25 years. To date, more than 1000 SSc patients have been transplanted worldwide. Overall and event-free survival have increased over the years, reflecting stricter patient selection criteria and better clinical management strategies. This review addresses long-term outcomes of transplanted SSc patients, considering phase I/II and randomized clinical trials, as well as observational studies and those assessing specific aspects of the disease. Clinical outcomes are discussed comparatively between studies, highlighting advances, drawbacks and controversies in the field. Areas for future development are also discussed.Keywords: systemic sclerosis, stem cell transplantation, long-term outcomes, progression-free surviva