{"doi":"10.1136/ard-2021-221925","title":"Myeloablative autologous haematopoietic stem cell transplantation resets the B cell repertoire to a more naïve state in patients with systemic sclerosis","abstract":"OBJECTIVES: Myeloablative autologous haematopoietic stem cell transplant (HSCT) was recently demonstrated to provide significant benefit over cyclophosphamide (CYC) in the treatment of diffuse cutaneous systemic sclerosis (dcSSc) in the Scleroderma: Cyclophosphamide or Transplantation (SCOT) trial. As dysregulation of the B cell compartment has previously been described in dcSSc, we sought to gain insight into the effects of myeloablative autologous HSCT as compared with CYC. METHODS: We sequenced the peripheral blood immunoglobulin heavy chain (IGH) repertoires in patients with dcSSc enrolled in the SCOT trial. RESULTS: Myeloablative autologous HSCT was associated with a sustained increase in IgM isotype antibodies bearing a low mutation rate. Clonal expression was reduced in IGH repertoires following myeloablative autologous HSCT. Additionally, we identified a underusage of immunoglobulin heavy chain V gene 5-51 in patients with dcSSc, and usage normalised following myeloablative autologous HSCT but not CYC treatment. CONCLUSIONS: Together, these findings suggest that myeloablative autologous HSCT resets the IGH repertoire to a more naïve state characterised by IgM-expressing B cells, providing a possible mechanism for the elimination of pathogenic B cells that may contribute to the benefit of HSCT over CYC in the treatment of dcSSc.","journal":"Annals of the Rheumatic Diseases","year":2022,"id":262490,"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":14,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9548,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2022-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":535222,"name":"Amin Zia","orcid":"0000-0002-1239-0857","position":1,"is_corresponding":false},{"id":331616,"name":"Michelle S. Bloom","orcid":"0000-0002-5755-3955","position":2,"is_corresponding":false},{"id":417981,"name":"Leslie J. Crofford","orcid":"0000-0002-6347-5738","position":3,"is_corresponding":false},{"id":24070,"name":"Daniel E. Furst","orcid":"0000-0001-7857-2373","position":4,"is_corresponding":false},{"id":321807,"name":"Ellen Goldmuntz","orcid":null,"position":5,"is_corresponding":false},{"id":462537,"name":"Lynette Keyes-Elstein","orcid":null,"position":6,"is_corresponding":false},{"id":332663,"name":"Maureen D. Mayes","orcid":"0000-0001-5070-2535","position":7,"is_corresponding":false},{"id":11137,"name":"Peter A. McSweeney","orcid":null,"position":8,"is_corresponding":false},{"id":417980,"name":"Richard A. Nash","orcid":"0009-0005-2683-5182","position":9,"is_corresponding":false},{"id":419096,"name":"Ashley Pinckney","orcid":null,"position":10,"is_corresponding":false},{"id":419095,"name":"Beverly Welch","orcid":null,"position":11,"is_corresponding":false},{"id":918257,"name":"Zelda Z. Love","orcid":"0000-0002-2478-7720","position":12,"is_corresponding":false},{"id":417982,"name":"Keith M. Sullivan","orcid":"0000-0002-1379-9216","position":13,"is_corresponding":false},{"id":226251,"name":"William H. Robinson","orcid":"0000-0003-4385-704X","position":14,"is_corresponding":false},{"id":331613,"name":"Julia Z. Adamska","orcid":"0000-0001-8657-4141","position":0,"is_corresponding":true}],"reference_count":40,"raw_metadata":null,"created_at":"2026-07-19T00:26:25.074177Z","pmid":"36241361","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":[]}