Systemic sclerosis & Raynaud's
Changes on chest high-resolution computed tomography (HRCT) in systemic sclerosis-related interstitial lung disease after autologous haematopoietic stem cell transplantation
Authors' conclusion
Real-world data analysis confirmed significant improvement in extent of HRCT SSc-ILD 24 months after aHSCT, although oesophageal dilatation worsened requiring specific attention.
Study context
- Population
- Early diffuse SSc patients undergoing autologous haematopoietic stem cell transplantation (aHSCT), routine yearly follow-up, January 2000–September 2016
- Participants
- 33 consecutive patients
- Exposure
- HRCT before vs after aHSCT
- Radiological respondersn = 18
- Outcome
- Extent of ILD on HRCT (semi-quantitative Goh and Wells method)
- Follow-up
- 24 months
Methodological detailssingle-group before–after, consecutive patients, blinded independent radiologist assessment, linear mixed model
- Single-group before–after
- Consecutive patients
- Blinded independent radiologist assessment
- Linear mixed model
Main finding
As reported in the abstract
12 and 24 months
- Interstitial lung disease (ILD) extent regression at 12 months
- P = 0.001
- Ground glass opacities regression at 12 months
- P = 0.0001
- ILD extent regression at 24 months
- P = 0.007
- Ground glass opacities regression at 24 months
- P = 0.0008
- Radiological responders at 24 months
- 18
- Probability of response
- 0.78 [95% CI 0.58, 0.90] (95% CI)
Observational data: associations, not effects.
Further findings
| Outcome | Non-responders | HR for death (95% CI) | P value | |
|---|---|---|---|---|
| 5-year survival, radiological respondersvs non-responders at 24 months (Kaplan-Meier)Trend towards better survival | 60% | 0.23 (0.03–1.62) | P = 0.11 | |
| 0.050.21520HR for death (log scale) |
- 5-year survival, radiological responders vs non-responders at 24 months (Kaplan-Meier): Responders 100%
Oesophageal dilatation: Widest oesophageal diameter (WOD) and oesophageal volume (OV) (increase) · 12 months
- WOD increased significantly
- WOD P = 0.03
- OV increase
- OV P = 0.34
Oesophageal dilatation: WOD and OV (increase) · 24 months
- WOD increased significantly
- WOD P = 0.002
- OV increased significantly
- OV P = 0.007
Original publication
Changes on chest HRCT in systemic sclerosis-related interstitial lung disease after autologous haematopoietic stem cell transplantation. Rheumatology (Oxford). Published 10 June 2022. doi:10.
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