ACR: Cyclophosphamide/Stem-Cell Transplant Provides Long-Term Benefit in Rheumatoid Arthritis

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ACR: Cyclophosphamide/Stem-Cell Transplant Provides Long-Term Benefit in

Rheumatoid Arthritis

By Emma Hitt

Special to DG News

NEW ORLEANS, LA -- October 30, 2002 -- High-dose cyclophosphamide followed

by autologous stem-cell transplantation may improve symptoms of rheumatoid

arthritis for as long as two years.

Dr. M. van Laar, with Leiden University Medical Center, the

Netherlands, presented his group's findings here Monday at the American

College of Rheumatology (ACR) 66th Annual Scientific Meeting.

The researchers treated 12 patients with active, progressively erosive

rheumatoid arthritis, who were refractory to conventional treatments. Each

of them received high-dose cyclophosphamide followed by autologous

hematopoietic stem-cell transplant.

Patient quality of life was assessed every three months for two years and

their hands and feet were X-rayed at baseline, one, and two years.

The mean quality of life improved in the first 15 to 18 months, the

researchers found. By 12 months, physical functioning improved (p=0.105), as

did role limitations (p=0.13), pain (p=0.03), vitality (p=0.04) and health

(p=0.05).

Dr. van Laar and colleagues also report that social functioning, mental

health, and general health perception were less affected, " although these

factors did improve. "

Similarly, progression of joint damage appeared to slow, and mobility,

walking and bending, hand and finger function, arm function, and ability to

perform household tasks improved.

" We are pleased with the apparent efficacy of this treatment, " Dr. van Laar

told Doctor¹s Guide, and he pointed out that the long-term benefit they saw

was greater than expected.

Patients who might benefit most from this type of treatment are those with a

therapy-refractory disease at risk of functional disability and early

mortality, he said.