Evidence map›Paper›PMID 34533286›Full record

Trial reportArthritis care & research2023

Clinical and Molecular Findings After Autologous Stem Cell Transplantation or Cyclophosphamide for Scleroderma: Handling Missing Longitudinal Data.

Lynette Keyes-Elstein, Ashley Pinckney, Ellen Goldmuntz, Beverly Welch, Jennifer M Franks, Viktor Martyanov, Tammara A Wood, Leslie Crofford, Maureen Mayes, Peter McSweeney and 9 more

Registry-linked trialOpen access · greenAbstract readRandomized Controlled Trial
In one paragraph

Trial report in Arthritis care & research, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT00114530 (A Randomized, Open-Label, Phase II Multicenter Study of High-Dose Immunosuppressive Therapy Using Total Body Irradiation, Cyclophosphamide, ATGAM, and Autologous Transplantation With Auto-CD34+HPC Versus Intravenous Pulse Cyclophosphamide for the Treatment of Severe Systemic Sclerosis), which is not on this map. Cited by 5 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 1 pooled it
1.1field-weighted citation impact, top 24% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT00114530 phase2 / phase3completednot on this map

A Randomized, Open-Label, Phase II Multicenter Study of High-Dose Immunosuppressive Therapy Using Total Body Irradiation, Cyclophosphamide, ATGAM, and Autologous Transplantation With Auto-CD34+HPC Versus Intravenous Pulse Cyclophosphamide for the Treatment of Severe Systemic Sclerosis (SCSSc-01)

TypeinterventionalSponsorNational Institute of Allergy and Infectious Diseases (NIAID)Ran2005 to 2016Enrolled75ConditionsScleroderma, Systemic, Sclerosis, Autoimmune DiseaseArmsmHSCT, cyclophosphamide
3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 1 synthesis or guideline pooled it, 9 citations in OpenAlex.

  1. Pooled it
  2. Trial
  3. Stem cell therapy in systemic sclerosis.Clinical rheumatology · 2025
    Review
  4. Review
  5. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

19 authors at 4 institutions in 2 countries.

Lynette Keyes-ElsteinRho Federal Systems Division, Durham, North Carolina.
Ashley PinckneyRho Federal Systems Division, Durham, North Carolina.
Ellen GoldmuntzNational Institute of Allergy and Infectious Diseases, Bethesda, Maryland.
Beverly WelchNational Institute of Allergy and Infectious Diseases, Bethesda, Maryland.
Jennifer M FranksGeisel School of Medicine at Dartmouth, Hanover, New Hampshire.
Viktor MartyanovGeisel School of Medicine at Dartmouth, Hanover, New Hampshire.
Tammara A WoodGeisel School of Medicine at Dartmouth, Hanover, New Hampshire.
Leslie CroffordVanderbilt University School of Medicine, Nashville, Tennessee.
Maureen MayesUniversity of Texas McGovern Medical School, Houston.ORCID 0000-0001-5070-2535
Peter McSweeneyColorado Blood Cancer Institute, Denver.
Richard NashColorado Blood Cancer Institute, Denver.
George GeorgesFred Hutchinson Cancer Research Center, Seattle, Washington.
M E CsukaMedical College of Wisconsin, Milwaukee.
Robert SimmsGeisel School of Medicine at Dartmouth, Hanover, New Hampshire.
Daniel FurstUniversity of California, Los Angeles, University of Washington, Seattle, and University of Florence, Florence, Italy.ORCID 0000-0001-7857-2373
Dinesh KhannaUniversity of Michigan, Ann Arbor.ORCID 0000-0003-1412-4453
E William St ClairDuke University Medical Center, Durham, North Carolina.
Michael L WhitfieldGeisel School of Medicine at Dartmouth, Hanover, New Hampshire.
Keith M SullivanDuke University Medical Center, Durham, North Carolina.ORCID 0000-0002-1379-9216
Dartmouth College · USFred Hutch Cancer Center · USMedical College of Wisconsin · USThe University of Texas Health Science Center at Houston · US

Funding

Transplantation GroupUM2AI117870 · NIAID · RHO FEDERAL SYSTEMS DIVISION, INC. · PI DAVID, GLORIA · 2015 to 2023
$208.1M
STEM CELL TRANSPLANTATION FOR TX OF AUTOIMMUNE DISEASES-N01AI5419N01AI005419 · NIAID · DUKE UNIVERSITY · PI SULLIVAN, KEITH M · 2000 to 2006
$6.2M
Quantitative Biomedical Sciences at DartmouthT32LM012204 · NLM · DARTMOUTH COLLEGE · PI TOSTESON, TOR D · 2016 to 2020
$876k
NIAID NIH HHS HHSN272200900057CNIAID NIH HHS HHSN272201100025CNIAID NIH HHS N01 AI005419NIAID NIH HHS N01 AI025481NIAID NIH HHS UM2 AI117870NLM NIH HHS T32 LM012204Wellcome Trust
6 · The paper itself

Abstract

objectiveAmong individuals with systemic sclerosis (SSc) randomized to cyclophosphamide (CYC) (n = 34) or hematopoietic stem cell transplantation (HSCT) (n = 33), we examined longitudinal trends of clinical, pulmonary function, and quality of life measures while accounting for the influence of early failures on treatment comparisons.

methodsAssuming that data were missing at random, mixed-effects regression models were used to estimate longitudinal trends for clinical measures when comparing treatment groups. Results were compared to observed means and to longitudinal trends estimated from shared parameter models, assuming that data were missing not at random. Longitudinal trends for SSc intrinsic molecular subsets defined by baseline gene expression signatures (normal-like, inflammatory, and fibroproliferative signatures) were also studied.

resultsAvailable observed means for pulmonary function tests appeared to improve over time in both arms. However, after accounting for participant loss, forced vital capacity in HSCT recipients increased by 0.77 percentage points/year but worsened by -3.70/year for CYC (P = 0.004). Similar results were found for diffusing capacity for carbon monoxide and quality of life indicators. Results for both analytic models were consistent. HSCT recipients in the inflammatory (n = 20) and fibroproliferative (n = 20) subsets had superior long-term trends compared to CYC for pulmonary and quality of life measures. HSCT was also superior for modified Rodnan skin thickness scores in the fibroproliferative subset. For the normal-like subset (n = 22), superiority of HSCT was less apparent.

conclusionLongitudinal trends estimated from 2 statistical models affirm the efficacy of HSCT over CYC in severe SSc. Failure to account for early loss of participants may distort estimated clinical trends over the long term.

Indexed as

Hematopoietic Stem Cell TransplantationScleroderma, LocalizedScleroderma, SystemicCyclophosphamideHumansImmunosuppressive AgentsQuality of LifeTransplantation, AutologousTreatment OutcomeCyclophosphamideImmunosuppressive Agents

Identifiers

PMID34533286
PMCPMC8926930
OpenAlexW3199564583

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.