Dr. Georges encourages rheumatologists to develop close educational relationships with their patients, helping steer them to reputable centers for these treatments. He also recommends referring physicians seek transplant evaluation before the disease is too advanced. “Patients with disease factors of poor prognosis should be referred to transplant ASAP, because the earlier you do it, the less organ damage there is,” says Dr. Georges. “And there is a lower risk of death from transplant. Once organ function is very impaired by the disease process, there is a greater risk of transplant mortality.”
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Moving forward, as HSCT for systemic sclerosis moves into more standard treatment, other severe autoimmune diseases may follow. Dr. Georges adds, “There are many rare neurologic autoimmune diseases that weren’t well recognized even 20 years ago, and some of these appear to be responding very well to HSCT. There may be other less frequently observed rheumatological diseases that may benefit, especially if there is not an effective treatment available for them.”
Ruth Jessen Hickman, MD, is a graduate of the Indiana University School of Medicine. She is a freelance medical and science writer living in Bloomington, Ind.
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