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Significant improvement of Takayasu arteritis after cord blood transplantation in a patient with myelodysplastic syndrome

Bone Marrow Transplantation volume 49, pages 458–459 (2014)Cite this article

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Autoimmune diseases (AID) sometimes coexist with hematological malignancies, and allogeneic hematopoietic SCT (HSCT) may be performed in patients with hematological neoplasms and AID.1, 2 Snowden et al.3 reported 1209 autologous and 64 allogeneic HSCTs in AID patients from the European Group for Blood and Marrow Transplantation database, and only 4 cases of allogeneic HSCT in patients with vasculitis were listed. Takayasu arteritis (TA) is characterized by large-vessel arteritis affecting the aorta and its primary branches, and it shows strong predominance in women. Oral prednisolone (PSL) is standard therapy, and second-line treatments—CY, MTX and CsA—are used for steroid-refractory patients. Several reports indicated an association between myelodysplastic syndrome (MDS) and TA.4, 5, 6, 7 We report a case of MDS and TA in which carotid artery stenosis was significantly improved after cord blood transplantation (CBT).

Allogeneic HSCT has been performed in patients with AID and hematological disorders.1, 2, 3, 8 Daikeler et al.8 performed a retrospective analysis of 35 patients receiving allogeneic HSCT for AID, and its response rate and TRM at 2 years were 79% (CR 55% and PR 24%) and 22.1%, respectively. They concluded that allogeneic HSCT can induce remission in patients with refractory AID. Graft-versus-autoimmune effect may be one factor underlying its effectiveness, and stem cell replacement itself may also have some effect in curing AID.9 Although there is now a substantial reduction in the risk of death related to allogeneic HSCT, the indication of allogeneic HSCT for AID is still controversial because of the high risks of treatment-related comorbidities.

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  1. Department of Hematology and Rheumatology, Tohoku University Hospital, Sendai, Japan

    H Kato, Y Onishi, S Nakajima, Y Okitsu, N Fukuhara, T Fujiwara, M Yamada-Fujiwara, J Kameoka, K Ishizawa & H Harigae

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  1. H Kato
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Correspondence to Y Onishi.

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Kato, H., Onishi, Y., Nakajima, S. et al. Significant improvement of Takayasu arteritis after cord blood transplantation in a patient with myelodysplastic syndrome. Bone Marrow Transplant 49, 458–459 (2014). https://doi.org/10.1038/bmt.2013.198

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