{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,15]],"date-time":"2026-08-15T04:27:42Z","timestamp":1786768062404,"version":"build-2736575974"},"reference-count":19,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T00:00:00Z","timestamp":1786665600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T00:00:00Z","timestamp":1786665600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["acrjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Arthritis Care &amp; Research"],"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Systemic sclerosis (SSc) is an autoimmune disease marked by immune dysregulation, leading to progressive fibrosis and multiorgan dysfunction. Autologous hematopoietic cell transplantation (autoHCT) has demonstrated superiority over conventional immunosuppression in randomized trials yet remains underused in the United States. We report outcomes following implementation of autoHCT as a standard\u2010of\u2010care strategy at our institution.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We performed a retrospective analysis of consecutive patients with severe SSc undergoing autoHCT between April 1, 2020, and December 31, 2023. Eligibility required progressive disease despite standard immunosuppressive therapy. Primary endpoints were overall survival (OS) and event free survival (EFS). Secondary endpoints included cumulative incidence of relapse and nonrelapse mortality (NRM), organ\u2010specific outcomes, and transplant\u2010related complications.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Twenty\u2010five patients underwent autoHCT. Median age was 46 years; 80% were female. At a median follow\u2010up of 23 (interquartile range 16.4\u201331.9) months, two\u2010year OS was 91.67% (95% confidence interval [CI] 81.25\u2013100.0) and EFS was 74.51% (95% CI 58.78\u201394.45). Two\u2010year cumulative incidence of relapse was 23.93% (95% CI 4.27 \u201343.59), and NRM was 8.33% (95% CI 2.97\u201319.64). Significant improvement in Modified Rodnan Skin Score was observed at day +90 and +180 (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.05), whereas pulmonary function stabilized. Infectious complications occurred in 56% of patients, primarily viral reactivations.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Implementation of autoHCT for severe SSc in a multidisciplinary care model was associated with favorable survival and meaningful improvement in skin disease, with acceptable toxicity. Earlier referral and optimization of conditioning strategies may further reduce relapse and treatment\u2010related morbidity.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/acr.80129","type":"journal-article","created":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T08:42:29Z","timestamp":1785487349000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Adopting a Standard of Care for Systemic Sclerosis: The Mayo Clinic Experience"],"prefix":"10.1002","author":[{"given":"Ernesto","family":"Ayala","sequence":"first","affiliation":[{"name":"Mayo Clinic  Jacksonville Florida"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6752-5440","authenticated-orcid":false,"given":"Madiha","family":"Iqbal","sequence":"additional","affiliation":[{"name":"Mayo Clinic  Jacksonville Florida"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tristan","family":"Meier","sequence":"additional","affiliation":[{"name":"Mayo Clinic Alix School of Medicine  Rochester Minnesota"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3095-2590","authenticated-orcid":false,"given":"Terri","family":"Menser","sequence":"additional","affiliation":[{"name":"Kern Center for the Science of Health Care Delivery, Mayo Clinic  Rochester Minnesota"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yihong","family":"Deng","sequence":"additional","affiliation":[{"name":"Kern Center for the Science of Health Care Delivery, Mayo Clinic  Rochester Minnesota"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hemant","family":"Murthy","sequence":"additional","affiliation":[{"name":"Mayo Clinic  Jacksonville Florida"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James","family":"Foran","sequence":"additional","affiliation":[{"name":"Mayo Clinic  Jacksonville Florida"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sikander","family":"Ailawadhi","sequence":"additional","affiliation":[{"name":"Mayo Clinic  Jacksonville Florida"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ricardo","family":"Parrondo","sequence":"additional","affiliation":[{"name":"Mayo Clinic  Jacksonville Florida"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohamed","family":"Kharfan\u2010Dabaja","sequence":"additional","affiliation":[{"name":"Mayo Clinic  Jacksonville Florida"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vivek","family":"Roy","sequence":"additional","affiliation":[{"name":"Mayo Clinic  Jacksonville Florida"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andy","family":"Abril","sequence":"additional","affiliation":[{"name":"Mayo Clinic  Jacksonville Florida"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,8,14]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra0806188"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/ker269"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.3324\/haematol.2009.013458"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.imlet.2017.11.005"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1703327"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(11)60982-3"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2014.6368"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bbmt.2018.01.020"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bbmt.2018.06.025"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.38098"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.5301\/jsrd.5000231"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.semarthrit.2025.152638"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/kez010"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1182\/bloodadvances.2017011072"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13045-016-0388-5"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.1981.00340060066015"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41409-020-0978-2"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.2147\/JBM.S489627"},{"key":"e_1_2_7_20_1","doi-asserted-by":"crossref","DOI":"10.1136\/bcr-2013-200639","article-title":"Coexistence of scleroderma with multiple myeloma: a rare association","volume":"2013","author":"Gajendra S","year":"2013","journal-title":"BMJ Case Rep."}],"container-title":["Arthritis Care &amp; Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/acrjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/acr.80129","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/acrjournals.onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/acr.80129","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/acrjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/acr.80129","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,15]],"date-time":"2026-08-15T03:58:17Z","timestamp":1786766297000},"score":1,"resource":{"primary":{"URL":"https:\/\/acrjournals.onlinelibrary.wiley.com\/doi\/10.1002\/acr.80129"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,14]]},"references-count":19,"alternative-id":["10.1002\/acr.80129"],"URL":"https:\/\/doi.org\/10.1002\/acr.80129","archive":["Portico"],"relation":{},"ISSN":["2151-464X","2151-4658"],"issn-type":[{"value":"2151-464X","type":"print"},{"value":"2151-4658","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,14]]},"assertion":[{"value":"2026-02-24","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-07-21","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-08-14","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"acr.80129"}}