Hematopoietic stem cell transplantation in chronic inflammatory demyelinating polyneuropathy: French experience about four patients, under the behalf of French society for bone marrow transplantation\n

Abstract

Chronic inflammatory demyelinating polyneuropathy (CIDP) is a disease that provokes myelin destruction in peripheral nervous system, leading to progressive motor and sensory loss. Therapeutic intensification with autologous peripheral hematopoietic stem cell transplantation (AHSCT) was first used to treat a refractory autoimmune disease in 1994 worldwide [1], and in 1997 in France (registry data). Over the past 20 years, the feasibility (phase I–II studies) and efficacy (phase II/III studies) of this procedure have been demonstrated in Europe and North America in several autoimmune diseases refractory to firstor second-line treatments. Thus in 2020, autologous hematopoietic stem cell transplantation is recommended as a second-line treatment for multiple sclerosis [2] or as a third-line treatment for other diseases, particularly neurological diseases such as CIDP [3]. In June 2020, Burt et al. published the first prospective study about AHSCT in CIDP concerning 66 patients [4]. Follow-up data were available for 60 patients. Post-transplant immune medication-free remission was 80%, 78%, 76% 78%, and 83% at 1, 2, 3, 4, and 5 years. There were no treatment-related deaths, and overall survival was 97%. We report here the first four patients treated by AHSCT for CIDP in France. One of the patients was also the first to receive an allogenic stem cell transplantation for the same indication because of relapse after first AHSCT.