{"doi":"10.1002/art.70031","title":"Long‐Term Outcomes of Reduced‐Intensity Conditioning Hematopoietic Stem Cell Transplantation for Patients With Systemic Sclerosis With Impaired Cardiac Function","abstract":"OBJECTIVE: High-intensity conditioning autologous hematopoietic stem cell transplantation (AHSCT) is standard of care for patients with advanced systemic sclerosis (SSc). The role of reduced-intensity conditioning (RIC) before AHSCT in this population remains unclear. We conducted this study to determine the long-term outcomes of RIC AHSCT in patients with SSc and cardiac involvement. METHODS: We evaluated 42 participants who sequentially underwent RIC AHSCT 5 years after the last participant was treated. Progression was defined as reinitiation of disease-modifying antirheumatic drugs or worsening end-organ failure. We determined overall survival (OS) and progression-free survival (PFS) by the Kaplan-Meier method and identified pretransplant characteristics associated with OS or PFS by multivariable Cox regression. RESULTS: All participants had evidence of SSc with cardiac involvement. Ninety-five percent of participants had interstitial lung disease. The median percent predicted forced vital capacity and diffusing capacity of the lungs for carbon monoxide was 62% and 45%, respectively. The 5-year OS was 75% (95% confidence interval [CI] 63%-90%), and 5-year PFS was 59% (95% CI 46%-76%). Pretransplant supplemental oxygen use (hazard ratio [HR] 7.88, P < 0.01) and elevated B-type natriuretic peptide (BNP; HR 1.005 per pg/mL, P < 0.01]) were associated with mortality. Anti-Scl-70 antibody positivity (HR 3.03, P = 0.02) was associated with progression. Twenty-four participants (57%) who did not use supplemental oxygen and had BNP <100 pg/mL pretransplant had a 5-year OS of 91% (95% CI 80%-100%). CONCLUSION: RIC AHSCT is safe for patients with severe manifestations from SSc. Supplemental oxygen use, elevated BNP, and anti-Scl-70 antibody positivity were risk factors for worse outcomes after RIC AHSCT.","journal":"Arthritis & Rheumatology","year":2025,"id":537602,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":1,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9538,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2025-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":312215,"name":"Carrie Richardson","orcid":"0000-0002-2541-175X","position":1,"is_corresponding":false},{"id":1423823,"name":"Anthony Esposito","orcid":null,"position":2,"is_corresponding":false},{"id":896042,"name":"Katy Bedjeti","orcid":"0000-0001-5910-112X","position":3,"is_corresponding":false},{"id":467812,"name":"George E. Georges","orcid":"0000-0002-0625-0858","position":4,"is_corresponding":false},{"id":1423397,"name":"Yonatan Moshe Lean","orcid":"0009-0008-4094-6497","position":0,"is_corresponding":true}],"reference_count":48,"raw_metadata":null,"created_at":"2026-07-19T02:52:12.997494Z","pmid":"41413348","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}