{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T19:53:26Z","timestamp":1792612406602,"version":"4.5.0"},"reference-count":51,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2026,3,27]],"date-time":"2026-03-27T00:00:00Z","timestamp":1774569600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,3,27]],"date-time":"2026-03-27T00:00:00Z","timestamp":1774569600000},"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 &amp;amp; Rheumatology"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>High\u2010intensity conditioning autologous hematopoietic stem cell transplantation (AHSCT) is standard of care for patients with advanced systemic sclerosis (SSc). The role of reduced\u2010intensity conditioning (RIC) before AHSCT in this population remains unclear. We conducted this study to determine the long\u2010term outcomes of RIC AHSCT in patients with SSc and cardiac involvement.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We evaluated 42 participants who sequentially underwent RIC AHSCT 5 years after the last participant was treated. Progression was defined as reinitiation of disease\u2010modifying antirheumatic drugs or worsening end\u2010organ failure. We determined overall survival (OS) and progression\u2010free survival (PFS) by the Kaplan\u2010Meier method and identified pretransplant characteristics associated with OS or PFS by multivariable Cox regression.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      All participants had evidence of SSc with cardiac involvement. Ninety\u2010five percent of participants had interstitial lung disease. The median percent predicted forced vital capacity and diffusing capacity of the lungs for carbon monoxide was 62% and 45%, respectively. The 5\u2010year OS was 75% (95% confidence interval [CI] 63%\u201390%), and 5\u2010year PFS was 59% (95% CI 46%\u201376%). Pretransplant supplemental oxygen use (hazard ratio [HR] 7.88,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.01) and elevated B\u2010type natriuretic peptide (BNP; HR 1.005 per pg\/mL,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.01]) were associated with mortality. Anti\u2013Scl\u201070 antibody positivity (HR 3.03,\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0=\u00a00.02) was associated with progression. Twenty\u2010four participants (57%) who did not use supplemental oxygen and had BNP &lt;100 pg\/mL pretransplant had a 5\u2010year OS of 91% (95% CI 80%\u2013100%).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>RIC AHSCT is safe for patients with severe manifestations from SSc. Supplemental oxygen use, elevated BNP, and anti\u2013Scl\u201070 antibody positivity were risk factors for worse outcomes after RIC AHSCT.<\/jats:p>\n                    <jats:p>\n                      <jats:boxed-text content-type=\"graphic\" position=\"anchor\">\n                        <jats:graphic xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" mimetype=\"image\/png\" position=\"anchor\" specific-use=\"enlarged-web-image\" xlink:href=\"graphic\/art70031-gra-0001-m.png\">\n                          <jats:alt-text>image<\/jats:alt-text>\n                        <\/jats:graphic>\n                      <\/jats:boxed-text>\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/art.70031","type":"journal-article","created":{"date-parts":[[2025,12,19]],"date-time":"2025-12-19T04:02:02Z","timestamp":1766116922000},"page":"1294-1305","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Long\u2010Term Outcomes of Reduced\u2010Intensity Conditioning Hematopoietic Stem Cell Transplantation for Patients With Systemic Sclerosis With Impaired Cardiac Function"],"prefix":"10.1002","volume":"78","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-4094-6497","authenticated-orcid":false,"given":"Yonatan","family":"Lean","sequence":"first","affiliation":[{"name":"Northwestern University Feinberg School of Medicine  Chicago Illinois"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carrie","family":"Richardson","sequence":"additional","affiliation":[{"name":"Division of Rheumatology Northwestern University Feinberg School of Medicine  Chicago Illinois"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anthony J.","family":"Esposito","sequence":"additional","affiliation":[{"name":"Division of Pulmonary and Critical Care Northwestern University Feinberg School of Medicine  Chicago Illinois"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katy","family":"Bedjeti","sequence":"additional","affiliation":[{"name":"Department of Medical Social Sciences Northwestern University Feinberg School of Medicine  Chicago Illinois"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"George E.","family":"Georges","sequence":"additional","affiliation":[{"name":"Division of Hematology and Oncology Northwestern University Feinberg School of Medicine  Chicago 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