Immune medications and surgeries after HSCT in patients with Crohn disease
| Patient . | Follow-up (actual), y* . | Medications/duration after HSCT, mo . | Gene† . | Other events . | |||||
|---|---|---|---|---|---|---|---|---|---|
| 6 . | 12 . | 24 . | 36 . | 48 . | 60 . | ||||
| 1 | 5 (9) | CCS | CCS | 0 | 0 | 0 | 3-year accidental death (no CD on autopsy) | ||
| 2 | 5 (9) | 0 | 0 | 0 | MES | 0 | CCS, MES | 0 | None |
| 3 | 5 (8) | 0 | 0 | 0 | CCS | CCS, MES, 6-MP, MTX | IFX | 0 | 6-month SBO rxs (no active CD); 3-year SBO (no surgery nasogastric suction); 5-year resection of anastomotic site ileum/transverse colon due to active CD stricture |
| 4 | 5 (8) | 0 | 0 | CCS, MES, MTX | MES, CYC | 0 | 0 | 0 | 4-year total colectomy (active CD) |
| 5 | 5 (8) | 0 | 0 | 0 | 0 | CCS, MES | NA | 0 | 2-year perianal fistulotomy |
| 6 | 5 (7) | 0 | 0 | IFX | IFX | IFX | 0 | 0 | None |
| 7 | 5 (6) | 0 | 0 | 0 | 0 | 0 | IFX | TLR5 | 4-year fistulotomy and dilatation anal stricture |
| 8 | 5 (6) | 0 | 0 | 0 | 0 | 0 | CCS | 0 | TPN for growth spurt 6 to12 months |
| 9 | 5 (6) | 0 | 0 | 0 | 0 | 0 | 0 | TLR5 | 18-month loop ileostomy closed (no active CD); 5-year dilatation and seton for perianal stricture resulting in perianal fistula |
| 10 | 5 (6) | 0 | 0 | CCS, TCL, 6-MP, IFX, MTX | 0 | 0 | 0 | 0 | 2-year aspergillosus in lung while on IFX;3-year partial colectomy (active CD); 5-year proctectomy (active CD) |
| 11 | 5 (6) | 0 | 0 | 0 | 0 | 0 | MES | 0 | 13-month rxs of ileum stricture and persistent enterocutaneous fistula (no active CD) |
| 12 | 5 | MES | CCS, MES | CCS, MTX | CCS, ADL | CCS | NTL | 0 | None |
| 13 | 5 | 0 | 0 | CCS, MES, AZA | CCS, MES, ADL, AZA, TPN | ADL | 0 | 0 | None |
| 14 | 5 | 0 | ADL | TPN, CCS, TCL, ADL | 0 | ADL | 0 | 0 | 30-month colectomy and ileostomy (active CD) |
| 15 | 5 | 0 | 0 | AZA, IFX | 0 | 0 | 0 | R702W | 2-year terminal ileum rxs stricturoplasty (active CD) intermittent antibiotic for bacterial overgrowth |
| 16 | 5 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | None |
| 17 | 4.6 | MNZ | 0 | 0 | 0 | 0 | 0 | 0 | 18-month colectomy and ileostomy (active CD) |
| 18 | 5 | CCS | CCS | CCS | 0 | 0 | 0 | 0 | None |
| 19 | 5 | CCS | 0 | 0 | 0 | ADL | 0 | TLR5 | 12-month diverting colostomy (no CD), reversed 6 months later, 44 months total colectomy (active CD) |
| 20 | 3 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | None |
| 21 | 3 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | None |
| 22 | 1 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 15-month cholecystectomy |
| 23 | 2 | 0 | 0 | CCS, 6-MP | 0 | 0 | 0 | 0 | None |
| 24 | 0.5 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | None |
| Patient . | Follow-up (actual), y* . | Medications/duration after HSCT, mo . | Gene† . | Other events . | |||||
|---|---|---|---|---|---|---|---|---|---|
| 6 . | 12 . | 24 . | 36 . | 48 . | 60 . | ||||
| 1 | 5 (9) | CCS | CCS | 0 | 0 | 0 | 3-year accidental death (no CD on autopsy) | ||
| 2 | 5 (9) | 0 | 0 | 0 | MES | 0 | CCS, MES | 0 | None |
| 3 | 5 (8) | 0 | 0 | 0 | CCS | CCS, MES, 6-MP, MTX | IFX | 0 | 6-month SBO rxs (no active CD); 3-year SBO (no surgery nasogastric suction); 5-year resection of anastomotic site ileum/transverse colon due to active CD stricture |
| 4 | 5 (8) | 0 | 0 | CCS, MES, MTX | MES, CYC | 0 | 0 | 0 | 4-year total colectomy (active CD) |
| 5 | 5 (8) | 0 | 0 | 0 | 0 | CCS, MES | NA | 0 | 2-year perianal fistulotomy |
| 6 | 5 (7) | 0 | 0 | IFX | IFX | IFX | 0 | 0 | None |
| 7 | 5 (6) | 0 | 0 | 0 | 0 | 0 | IFX | TLR5 | 4-year fistulotomy and dilatation anal stricture |
| 8 | 5 (6) | 0 | 0 | 0 | 0 | 0 | CCS | 0 | TPN for growth spurt 6 to12 months |
| 9 | 5 (6) | 0 | 0 | 0 | 0 | 0 | 0 | TLR5 | 18-month loop ileostomy closed (no active CD); 5-year dilatation and seton for perianal stricture resulting in perianal fistula |
| 10 | 5 (6) | 0 | 0 | CCS, TCL, 6-MP, IFX, MTX | 0 | 0 | 0 | 0 | 2-year aspergillosus in lung while on IFX;3-year partial colectomy (active CD); 5-year proctectomy (active CD) |
| 11 | 5 (6) | 0 | 0 | 0 | 0 | 0 | MES | 0 | 13-month rxs of ileum stricture and persistent enterocutaneous fistula (no active CD) |
| 12 | 5 | MES | CCS, MES | CCS, MTX | CCS, ADL | CCS | NTL | 0 | None |
| 13 | 5 | 0 | 0 | CCS, MES, AZA | CCS, MES, ADL, AZA, TPN | ADL | 0 | 0 | None |
| 14 | 5 | 0 | ADL | TPN, CCS, TCL, ADL | 0 | ADL | 0 | 0 | 30-month colectomy and ileostomy (active CD) |
| 15 | 5 | 0 | 0 | AZA, IFX | 0 | 0 | 0 | R702W | 2-year terminal ileum rxs stricturoplasty (active CD) intermittent antibiotic for bacterial overgrowth |
| 16 | 5 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | None |
| 17 | 4.6 | MNZ | 0 | 0 | 0 | 0 | 0 | 0 | 18-month colectomy and ileostomy (active CD) |
| 18 | 5 | CCS | CCS | CCS | 0 | 0 | 0 | 0 | None |
| 19 | 5 | CCS | 0 | 0 | 0 | ADL | 0 | TLR5 | 12-month diverting colostomy (no CD), reversed 6 months later, 44 months total colectomy (active CD) |
| 20 | 3 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | None |
| 21 | 3 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | None |
| 22 | 1 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 15-month cholecystectomy |
| 23 | 2 | 0 | 0 | CCS, 6-MP | 0 | 0 | 0 | 0 | None |
| 24 | 0.5 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | None |
ADL indicates adalimumab; AZA, azathioprine; CCS, corticosteroids (of any type including oral budesonide); CYC, cyclophosphamide; IFX, infliximab; 6-MP, 6-mercaptopurine; MES, mesalamine; MNZ, metronidazole; MTX, methotrexate; NA, not available; NTL, natalizumab; TCL, tacrolimus; TPN, total parenteral nutrition; rxs, resection; and SBO, small bowel obstruction.
Follow-up data limited to 5 years (actual time since transplantation).
Gene describes genetic analysis, all polymorphisms were heterozygous.