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<p>Secondary autoimmune and inflammatory diseases (SAIDs) are underrecognized and poorly described after allogeneic hematopoietic stem cell transplantation (allo-HSCT). The standardization of management is hindered by the scarcity of data on epidemiology, pathogenesis, and clinical outcomes. To improve the evidence base, we performed a retrospective multicenter EBMT database study of patients who underwent allo-HSCT between 2005 and 2019 for either hematological malignancy or severe aplastic anemia with available information on SAIDs. We included 129 cases of SAIDs and 14,617 controls. The 5-year incidence of SAIDs was 0.9% (95% confidence interval (CI): 0.7–1.1), and the 10-year incidence was 1.1% (95% CI: 0.9–1.3). The median time from allo-HSCT to the diagnosis of SAIDs was 442 days [interquartile range (IQR): 242–1082]. Overall survival after the onset of SAIDs was 83.4% (95% CI 74.6–89.3) at 2 years and 73.4% (95% CI: 62–82) at 5 years. In multivariate analysis, risk factors significantly associated with SAIDs were bone marrow failure (Hazard Ratio (HR): 3.41 [95% CI, 1.55–7.52], <i>p</i> = 0.002), female donor to male patient (HR 1.77 [95% CI, 1.15–2.73], <i>p</i> = 0.009), and the presence of chronic GvHD (HR 1.61 [95% CI, 1.04–2.51], <i>p</i> = 0.034). SAIDs after allo-HSCT are rare but clinically significant entities requiring further investigations, exploring treatment and prevention strategies, as well as improving diagnostic approaches.</p>

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Secondary autoimmune and inflammatory diseases after allogeneic hematopoietic stem cell transplantation: a retrospective study from the EBMT transplant complications and autoimmune diseases working parties

  • 期刊论文

  • 发表日期：

    2026年7月27日

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  • Arsene Mekinian,
  • Artem Oganesyan,
  • Zinaida Perić,
  • Myriam Labopin,
  • Urpu Salmenniemi,
  • José Antonio Pérez Simón,
  • Anke Verlinden,
  • Ioanna Sakellari,
  • Mohsen Alzahrani,
  • Massimo Martino,
  • Frédéric Baron,
  • John A. Snowden,
  • Hakan Ozdogu,
  • Alexander Kulagin,
  • Edgar Jost,
  • Anna Torrent,
  • Fabio Benedetti,
  • Anna De Becker,
  • Sylvie François,
  • Montserrat Rovira,
  • Hans Christian Reinhardt,
  • Alessandra Biffi,
  • Mark Ringhoffer,
  • Pascal Ambron,
  • Jose Luis López Lorenzo,
  • Nabil Yafour,
  • Alexandre Galvagni,
  • Manuela Badoglio,
  • Ivan Moiseev,
  • Tobias Alexander,
  • Mohamad Mohty,
  • Olivier Fain,
  • Raffaella Greco,
  • Olaf Penack

摘要

Secondary autoimmune and inflammatory diseases (SAIDs) are underrecognized and poorly described after allogeneic hematopoietic stem cell transplantation (allo-HSCT). The standardization of management is hindered by the scarcity of data on epidemiology, pathogenesis, and clinical outcomes. To improve the evidence base, we performed a retrospective multicenter EBMT database study of patients who underwent allo-HSCT between 2005 and 2019 for either hematological malignancy or severe aplastic anemia with available information on SAIDs. We included 129 cases of SAIDs and 14,617 controls. The 5-year incidence of SAIDs was 0.9% (95% confidence interval (CI): 0.7–1.1), and the 10-year incidence was 1.1% (95% CI: 0.9–1.3). The median time from allo-HSCT to the diagnosis of SAIDs was 442 days [interquartile range (IQR): 242–1082]. Overall survival after the onset of SAIDs was 83.4% (95% CI 74.6–89.3) at 2 years and 73.4% (95% CI: 62–82) at 5 years. In multivariate analysis, risk factors significantly associated with SAIDs were bone marrow failure (Hazard Ratio (HR): 3.41 [95% CI, 1.55–7.52], p = 0.002), female donor to male patient (HR 1.77 [95% CI, 1.15–2.73], p = 0.009), and the presence of chronic GvHD (HR 1.61 [95% CI, 1.04–2.51], p = 0.034). SAIDs after allo-HSCT are rare but clinically significant entities requiring further investigations, exploring treatment and prevention strategies, as well as improving diagnostic approaches.