To describe the first three cases of severe myasthenia gravis treated with autologous hematopoietic stem cell transplantation at the 108 Military Central Hospital in Vietnam. Methods: From March 16, 2021 to September 30, 2022, a prospective study of three cases with severe myasthenia gravis was conducted at 108 Military Central Hospital; the average follow-up was 10 months (5 months-16 months). Despite receiving vigorous immunosuppressive medication, all patients had severe, persistent myasthenia gravis. Cyclophosphamide and G-CSF were used to isolate autologous hematopoietic stem cells from peripheral blood, and CD34 selection was used to eliminate out autoimmune lymphocytes. After undergoing conditioning regimens to disable the patient's auto-immune system, stem cells were retransfused to help the patient's blood and immunity return. Results: The mean age at myasthenia gravis diagnosis and at the time of transplantation was 23.6 years and 39.6 years, respectively. Three patients underwent autologous hematopoietic stem cell transplantation. Clinical symptoms, electromyography showing myasthenia gravis (class IIb - III), and a positive anti-Acetylcholine antibody titer were all present in all individuals. Following the transplant, all three patients showed a significant improvement, the condition was stable and in remission, and they no longer required immunosuppressive medication. None of the three patients (100%) who underwent autologous hematopoietic stem cell transplantation experienced superinfection or autoimmune illness as a result. Conclusion: Patients with severe myasthenia gravis can significantly decrease their severity of symptoms without additional immunosuppressive therapy with autologous hematopoietic stem cell transplantation. The successful use of autologous hematopoietic stem cell transplantation for patients with severe myasthenia gravis provides them with new options, faith in treatment, and the ability to return to the community.
Lọc theo danh mục
Lượt truy cập :
19,312,300
Xem toàn văn