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Patients with systemic sclerosis (SSc) have limited treatment options and the disease is associated with high disease related mortality.1 Autologous hematopoietic stem cell transplantation (HSCT) has been proven to be effective in selected progressive SSc patients.2–4 The goal of HSCT is a reset of the autoaggressive immune system by using immunoablative chemotherapies in combination with antibodies directed against lymphocytes before reinfusion of stem cells. Major concerns are infectious complications after HSCT. In 2020, COVID-19 led to highly increased death rates in the populations around the world and thus to major reservations with regards to HSCT in autoimmune diseases. In most of the centres, HSCT programmes for SSc were stopped and only restarted in special settings or after vaccination was available.5 This is the first single centre experience of COVID infections after HSCT for SSc. We report on six consecutive patients transplanted during the last year of which four developed a COVID-19 infection after HSCT. Mobilisation and conditioning were performed as described previously with cyclophosphamide (CYC) and antithymocyte globuline (ATG) or with reduced CYC, thiotepa and ATG …
Handling editor Josef S Smolen
Contributors JCH: planning, coordination, conduct and writing. IM: conducting laboratory tests for T-cell reaction. WV: reporting. CL: reporting. RK: conducting laboratory tests for autoantibodies and COVID antibody testing. LH: conducting laboratory tests for T-cell reaction. A-CP: Planning, coordination of laboratory tests and reporting.
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.
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