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Autologous haematological stem cell transplantation (AHSCT) for rapidly progressive severe systemic sclerosis (SSc) is the only treatment, so far, allowing long-term improvement in overall and event-free survival.1 2 The COVID-19 pandemic has challenged experts regarding decisions on AHSCT in these high-risk patients.3 Increased risk for severe COVID-19 infection in SSc is related to lung and heart involvement4 and is enhanced by high-dose immunosuppressive drugs and antithymocyte globulins used for conditioning to eliminate autoreactive cells before AHSCT and to allow reset of tolerance during the immune reconstitution period, lasting around 12 months after transplant.1 3 Several centres have stopped AHSCT activity for SSc during the pandemic for safety considerations. Others decided to continue, believing that the benefit of AHSCT is greater than the …
Footnotes
Handling editor Josef S Smolen
Twitter @doronrimar@gmail.com
Contributors All authors took part in collecting data writing and reviewing the letter and approved its final revision for publication.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests None declared.
Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.
Provenance and peer review Not commissioned; externally peer reviewed.