Outcomes of autologous hematopoietic stem cell transplantation in patients with refractory Crohn’s disease: a single-center retrospective case series
| Journal | Volume 89 - 2026 |
| Issue | Fasc.2 - Original articles |
| Author(s) | G. Geebelen 1, A. Van Besien 1, J. Van Ham 2, A.T. D'Hooghe 1 3, M. Ferrante 1 3, J. Sabino 1 3, B. Verstockt 1 3, D. Dierickx 2 4, S. Vermeire 1 3 |
| Full article |
 PAGES 325-332 VIEW FREE PDF |
| DOI | 10.51821/89.2.15503 |
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Affiliations: (1) University Hospitals Leuven, Department of Gasteroenterology & Hepatology, B-3000 Leuven, Belgium
(2) University Hospitals Leuven, Department of Hematology, B-3000 Leuven, Belgium (3) KU Leuven, Department of Chronic Diseases & Metabolism, B-3000 Leuven, Belgium (4) KU Leuven, Department of Oncology, B-3000 Leuven, Belgium |
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Background and aims: Despite advances in biological therapies, a subset of patients with Crohn’s disease (CD) remains or becomes refractory to all available treatments. Emerging evidence indicates that autologous hematopoietic stem cell transplantation (aHSCT) may offer a viable therapeutic option for carefully selected treatment-refractory CD patients. Patients and methods: We retrospectively analyzed the outcomes of all CD patients who underwent aHSCT for treatment-refractory disease at our IBD referral center between 2011 and 2023. All included patients had severe disease, unsuitable for surgery. Results: We included 24 CD patients (15 females, median age at transplantation 31.0 [27.0-34.5] years, median disease duration 13.0 [9.8-17.3] years) who underwent mobilization, of whom 23 patients proceeded to transplantation. All patients had CD with small bowel involvement, while 10 patients (41.7%) had concomitant perianal disease. After a median follow-up of 114.6 [66.0-138.4] months, 8 patients (34.8%) were still in remission without need for advanced therapy. Persistent disease activity after aHSCT, defined as total SES-CD >3, occurred in 15 patients (65.2%) with median time to restarting advanced therapy of 7.0 [5.0-25.0] months. At last follow-up, all patients are still alive. There were a few ICU admissions because of hemodynamic instability due to neutropenic fever following mobilization and transplantation. In the follow-up period, infectious complications occurred in 12 patients (52.2%). Conclusions: Autologous hematopoietic stem cell transplantation is a safe and effective therapy for inducing and maintaining remission in carefully selected therapy-refractory CD patients after extensive multidisciplinary discussion. Although many patients didn’t achieve remission, most regained response to previously ineffective therapies Keywords: Crohn’s disease, autologous hematopoietic stem cell transplantation, efficacy; safety. |
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© Acta Gastro-Enterologica Belgica. PMID 42417636 |