HSCT Not Linked to Sustained Remission in Refractory Crohn's
(HealthDay News) — For adult patients with refractory Crohn's disease with impaired quality of life, autologous hematopoietic stem cell transplantation (HSCT) is not associated with sustained disease remission at one year, according to a study published in the December 15 issue of the Journal of the American Medical Association.
Christopher J. Hawkey, FMedSci, from the Nottingham Digestive Diseases Center in the United Kingdom, and colleagues examined the effect of autologous HSCT on refractory Crohn's disease in a randomized trial. Patients, aged 18 to 50 years, with impaired quality of life from refractory Crohn's disease were randomized to immunoablation and HSCT (23 patients) or control treatment (HSCT deferred for one year; 22 patients).
The researchers observed no significant between-group differences in the proportion of patients achieving sustained disease remission (8.7 versus 4.5%; P = 0.60). No significant between-group differences were seen in the proportion of patients with Crohn's Disease Activity Index <150 in the past three months (P = 0.052) or in freedom from active disease (P = 0.054). There was a statistically significant between-group difference in the proportion of patients able to discontinue treatment for at least three months (P = 0.01). Seventy-six serious adverse events were recorded in patients undergoing HSCT compared with 38 in controls. One patient in the HSCT group died.
"These findings do not support the widespread use of HSCT for patients with refractory Crohn's disease," the authors write.