Outcomes of patients with hematological malignancies complicated with autoimmune diseases after allogeneic hematopoietic stem cell transplantation: A ten-year real-world study.

BACKGROUND AND OBJECTIVES: Patients with autoimmune diseases (ADs) are at an increased risk of developing hematological malignancies (HMs). While allogeneic hematopoietic stem cell transplantation (allo-HSCT) is a curative option for HMs, the outcomes in patients with concomitant ADs and the effects of transplantation on autoimmune conditions remain poorly characterized. METHODS: In this real-world study, we compared transplantation outcomes between 41 patients with HMs and preexisting ADs and 123 matched controls with HMs but without ADs. RESULTS: A total of 65.8% of the patients with ADs had a disease duration of ≥ 3 years. All patients achieved hematological recovery. The AD group had a significantly higher incidence of chronic graft-versus-host disease (70.7% vs. 26.8%, P < 0.001). After a median follow-up of 24 (8-75) months, the 3-year overall survival (73.2% [95% CI: 60.2%-89.1%] vs. 76.3% [95% CI: 68.9%-84.4%], P = 0.76) and disease-free survival rates (68.8% [95% CI: 55.6%-85.3%] vs. 74.7% [95% CI: 67.2%-82.9%], P = 0.57) were comparable between the AD and control groups. No significant differences were observed in the 3-year cumulative incidence of relapse (7.7% [95% CI: 1.9%-18.8%] vs. 9.5% [95% CI: 5.0%-15.7%], P = 0.61) or nonrelapse mortality (23.5% [95% CI: 11.5%-38.0%] vs. 16.7% [95% CI: 10.6%-23.9%], P = 0.40). Multivariable analysis confirmed that preexisting AD was not an independent risk factor for survival, relapse, or nonrelapse mortality. CONCLUSIONS: Our results suggest that allo-HSCT in patients with HMs and ADs is associated with survival outcomes that appear comparable to those in patients without ADs but also induces complete remission of AD in most patients.