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EBMT 2022 | An overview of the aims & work of the ADWP

Raffaella Greco, MD, PhD, San Raffaele Hospital, Milan, Italy, summarizes the aims and activity of the Autoimmune Diseases Working Party (ADWP) in the field of hematopoietic stem cell transplantation (HSCT) for autoimmune disorders. The ADWP is currently following more than 3,700 patients with autoimmune disorders treated with HSCT. Dr Greco explains that the ADWP works closely with transplant physicians and disease specialists, as well as other disease working parties to improve patient outcomes and clinical practice, better understand transplant complications, and expand the use of cellular therapies like chimeric antigen receptor T-cell (CAR-T) therapies to autoimmune diseases including multiple sclerosis (MS) and scleroderma. Moving forward, Dr Greco highlights some of the sessions on transplantation in autoimmune disorders that took place at EBMT. Lastly, Dr Greco mentions the growing interest in using allogeneic HSCT (alloHSCT) to treat autoimmune disorders. This interview took place at the 48th Annual Meeting of the European Group for Blood and Marrow Transplantation (EBMT) 2022, which was held virtually.

Transcript (edited for clarity)

I think that nowadays we have a growing interest for all non-malignant disorders, regarding the cellular therapies and transplantation. In particular, the Autoimmune Diseases Working Party, a working party within the EBMT who contribute with really the largest registry of that type in the world with also the transplant indication and also cellular therapy used in all the types of autoimmune disorders...

I think that nowadays we have a growing interest for all non-malignant disorders, regarding the cellular therapies and transplantation. In particular, the Autoimmune Diseases Working Party, a working party within the EBMT who contribute with really the largest registry of that type in the world with also the transplant indication and also cellular therapy used in all the types of autoimmune disorders. We are really covering now within the EBMT more than 3,700 patients with autoimmune disorders treated with hematopoietic stem cell transplantation. And I think that one of the aims of our working party is related to being a multidisciplinary team. So not only a hematologist and transplant physician, but also a deep connection in our group with the disease specialists: neurologists, rheumatologists, gastroenterologists. And also we have a sort of a good connection in terms of cross fertilization with other working parties.
So we are working together also regarding transplant complications, in the complication more related to autoimmunity and autoinflammation. And also with the innovative cellular therapy with the Cellular Therapy and the Immunobiology Working Party, because we are involved with for the future also in the CAR-T project with the autoinflammatory and autoimmune complication after CAR-T therapies. So really we are facing a new era also for the autoimmune disorders. We have important results in our field that also give us two standard indications nowadays for autologous stem cell transplantation in the field. And these are for multiple sclerosis and scleroderma. So these are undoubtedly the two main indications we have in the registry for autologous stem cell transplantation. And we are now working with the whole community and all of the disease specialists to have this standard indication also used throughout the hospital, the center and the community, not only within EBMT, but also in the disease specific community outside EBMT. So I think this is really an important effort in our society. And we also really aim to cover for the future these new fields regarding the cellular therapy and also the cross fertilization. And also it is important to underline that nowadays we are also working with our disease specialists and our transplant physicians in the team on the best patient selection, the best conditioning regimen, the best monitoring after the transplant. So I think that we can really improve the outcome of transplantations in this field of autoimmune disorders as we have seen in the two session of this EBMT. We have seen a workshop dedicated to autoimmune disorders, that is workshop three, you can also see on demand. And also the Autoimmune Disease Working Party session yesterday, that can be also available on demand afterwards. And during this day, we have seen several presentations by our key working party members showing for example, the importance of patient selection to perform transplantation in Crohn’s disease, in scleroderma, and also multiple sclerosis.
This really can improve our clinical practice in the field because we are having more centers that are facing and starting the transplant programs in this setting. So it is important to guide also the physician in this field. And also we have guidelines that have been published recently to improve the clinical practice in the field. And regarding, for example, also the workshop we have seen yesterday, you can see here a really comprehensive overview about autologous stem cell transplantation and the main indication, multiple sclerosis, scleroderma, and also some results regarding not only the autologous stem cell transplantation, but also the allogenic procedure. Because we have also conducted in the past, studies regarding the allogeneic stem cell transplantation in this field that nowadays also is reserved for the most severe and refractory cases. But I think that also giving the low toxicity of allotransplant procedure that we are facing in the hematological field nowadays, that can be also more space for allogeneic stem cell transplantation, non-malignant disorders, including autoimmune diseases, for the future.

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