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Volume 3 Supplement 2

21st European Workshop for Rheumatology Research

  • Meeting abstract
  • Open Access

Infiltrate analysis of rheumatoid synovial tissue before and after high does chemotherapy and autologous stem cell transplantation

  • 1,
  • 1,
  • 1,
  • 2,
  • 1 and
  • 1
Arthritis Research & Therapy20013 (Suppl 2) :P096

https://doi.org/10.1186/ar265

  • Received: 15 January 2001
  • Published:

Keywords

  • Public Health
  • Rheumatoid Arthritis
  • Arthritis
  • Cyclophosphamide
  • Clinical Response

Objective

To investigate the effects of high dose chemotherapy (HDC) and autologous stem cell transplantation (ASCT) on the synovial infiltrate in rheumatoid arthritis.

Methods

8 patients with erosive, refractory, progressively rheumatoid arthritis, were treated with HDC (cyclophosphamide 200 mg/kg) and CD34 enriched selected ASCT. Biopsies of synovial tissue from a clinically involved knee were obtained by arthroscopy before and three months after HDC and ASCT. Immunohistochemistry was performed and blindly scored on a five point scale (0-4) using MoAbs specific for the following markers: CD3, CD4, CD8, CD25, CD27, CD45RA, CD45RO, CD45RB, CD19, CD20, CD22, CD38, CD5, CD68, HLA-DR, CD62L, CD62E, CD56 and CD55.

Results

There were no statistical significant differences (Wilcoxon's signed rank test) when the results before and after transplantation were compared. However when patients were divided in clinical responders (ACR > 50%, n = 5) and non-responders (ACR < 20%, n = 3) statistically significant differences with respect to several T-cell markers were found (Table).

Table 1

 

Responders

Non-responders

 
 

Before

After

Before

After

P *

CD 3

2.8 ± 0.5

1.3 ± 2.3

1.0 ± 1.4

1.7 ± 2.1

0.06

CD27

3.0 ± 0.8

0.3 ± 0.6

1.0 ± 0.8

1.7 ± 2.1

0.05

CD45RA

2.3 ± 0.9

0.7 ± 1.2

0.5 ± 1

1.6 ± 2.1

0.03

CD45RO

3.4 ± 0.5

0.7 ± 1.2

1.8 ± 1.6

2.0 ± 2

0.04

CD45RB

3.2 ± 0.8

1.0 ± 1.7

2.0 ± 1.6

2.0 ± 2.0

0.05

Mean Histological Score ± STDEV. * Mann-Whitney U test. Clinical and immunohistochemical responses were predicted by CD27 (P = 0.016), CD45RO (P = 0.003) and CD45RB (P = 0.047) infiltration before treatment.

Conclusions

There was a statistically significant difference (P < 0.05) between clinical responders and non-responders with respect to a decrease in infiltration of CD45RA+ and CD45RO+ cells after HDC and ASCT. CD27, CD45RO and CD45RB appear to be useful markers to predict clinical response.

Authors’ Affiliations

(1)
Department of Rheumatology, Leiden University Medical Center, The Netherlands
(2)
Department of Rheumatology, University of Nijmegen, The Netherlands

Copyright

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