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Immunoablation and autologous hematopoietic stem cell transplantation in the treatment of new-onset type 1 diabetes mellitus: long-term observations

Bone Marrow Transplantation volume 51, pages 398–402 (2016)Cite this article

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Abstract

The activity of the autoimmune mechanism underlying type 1 diabetes mellitus (T1DM) can be suppressed when immunoablation and autologous hematopoietic stem cell transplantation (AHSCT) are applied early in the course of the disease. We report here a single centre experience with this treatment modality. Twenty-four patients underwent a AHSCT preceded by immunoablative conditioning with high-dose cyclophosphamide and anti-thymocyte globulin. During the 52-month median time of follow-up 20 out of 23 patients (87%) remained for at least 9.5 months without the use of exogenous insulin. The median time of T1DM remission for these patients was 31 months (range of 9.5–80 months). Among the patients available for follow-up (n=20), four remain insulin free (for 80, 61, 42 and 34 months). The average glycated hemoglobin (HbA1c) concentrations were 10.9% at diagnosis, 5.9% at 1 year, 6.4% at 2 years, 6.8% at 3 years and 7.1% at 4 years after AHSCT. No severe complications of diabetes were seen, however one of the patients died of pseudomonas sepsis in the course of neutropenia after AHSCT. AHSCT leads to a remission of T1DM with good glycemic control in the vast majority of patients, with the period of remission lasting over 5 years in some patients.

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Acknowledgements

We thank Małgorzata Marczewska for her editorial help in the preparation of this manuscript.

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Authors and Affiliations

  1. Department of Hematology, Oncology and Internal Medicine, Medical University of Warsaw, Warszawa, Poland

    E Snarski, K Hałaburda, T Torosian, M Paluszewska, E Urbanowska, M Król, P Boguradzki & W Wiktor-Jedrzejczak

  2. Department of Internal Medicine, Diabetology and Endocrinology, Central Hospital, Ministry of Internal Affairs and Administration, Warszawa, Poland

    A Milczarczyk, K Jedynasty & E Franek

  3. Mossakowski Medical Research Centre, Polish Academy of Sciences, Warszawa, Poland

    E Franek

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  1. E Snarski
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Correspondence to E Snarski.

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Snarski, E., Milczarczyk, A., Hałaburda, K. et al. Immunoablation and autologous hematopoietic stem cell transplantation in the treatment of new-onset type 1 diabetes mellitus: long-term observations. Bone Marrow Transplant 51, 398–402 (2016). https://doi.org/10.1038/bmt.2015.294

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