High-dose immunosuppressive therapy with autologous hematopoietic stem cell transplantation in systemic autoimmune pathology: focus on systemic sclerosis

The incidence of autoimmune diseases is increasing worldwide. Systemic sclerosis (SSc) is more common in young adults and is characterized by extensive progressive fibrotic lesions of the skin and other organs. The rapidly progressive diffuse form of SSc can lead to short-term mortality in 30% of cases. High-dose immunosuppressive therapy with autologous hematopoietic stem cell transplantation (HDIT-AHSCT) has multiple immune-mediated effects that can reduce clinical manifestations and improve prognosis in patients with SSc. The method has been used for SSc since 1997. Approximately 900 transplant procedures for SSc have been performed within the registry of the European Society for Blood and Marrow Transplantation (EBMT). This paper analyzes the results of randomized clinical trials (ASSIST, ASTIS, SCOT) using HDIT-AHSCT in SSc. It presents patient group characteristics, conditioning regimens, and efficacy compared to standard therapies. The criteria and patient selection process, as well as indications and contraindications for the procedure, are also presented. This information can be used to further justify the expansion of care options for patients with SSc in the Russian Federation.

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