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Early morbimortality in autologous hematopoietic cell transplantation performed on outpatient basis in patients with autoimmune diseases: experience in 1700 patients

Bone Marrow Transplantation volume 60, pages 640–644 (2025)Cite this article

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Abstract

Autologous hematopoietic cell transplantation (aHSCT) is a viable therapeutic approach in patients with autoimmune diseases. Since June 2015, we have autografted on an outpatient basis 1700 aHSCT patients. The objective was to analyze the salient features of early post-aHSCT complications when performed in the outpatient setting. The primary endpoints were early morbi-mortality-free survival (MFS) and overall survival (OS), whereas secondary endpoints entailed hospital admissions, neutropenic fever, Multiple Sclerosis (MS) flare-up, pneumothorax, hyponatremia and myocarditis. Following the “Mexican Method”; 1700 consecutive aHSCT recipients were analyzed: 1667 with MS, 29 with CIDP and 4 with other autoimmune diseases. A total of 1643 (96.6%) grafts were fully completed in the outpatient setting. The 30-day MFS and 30-day OS were 87.7% and 99.8%, respectively. The 30-day MFS has increased from 94.9% in the first 5 years to 98.2% in the last 5 years (p = 0.0002). The 28-day mortality was 0.17%, whereas the 28-day morbidity was 3.3%. The rate of early complications decreased over time, most likely reflecting a learning curve effect. These data support that employing our method is safe in the short term; as this has been done in a ‘trial’ setting, further research is needed.

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Fig. 1: The “Mexican method” conditioning regimen for aHSCT for autoimmune diseases.
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To ensure the protection of our patients’ data, we declare that such information is not available for use, sharing, or distribution. We are committed to maintaining the confidentiality and security of our patients’ health data, in accordance with applicable laws and regulations.

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Authors and Affiliations

  1. Centro de Hematología y Medicina Interna, Clínica Ruiz, Puebla, Mexico

    Olivia Lira-Lara, Max Robles-Nasta, Juan Carlos Olivares-Gazca, Montserrat Rivera-Álvarez, Danae García-Vélez, Michelle Lavoignet-Cisneros, Mónica D. Salgado-Cabrera, Guillermo J. Ruiz-Delgado & Guillermo J. Ruiz-Argüelles

  2. Universidad Veracruzana, Veracruz, Veracruz, Mexico

    Olivia Lira-Lara & Michelle Lavoignet-Cisneros

  3. Universidad Popular Autónoma del Estado de Puebla, Puebla, Mexico

    Max Robles-Nasta, Juan Carlos Olivares-Gazca, Montserrat Rivera-Álvarez, Danae García-Vélez, Guillermo J. Ruiz-Delgado & Guillermo J. Ruiz-Argüelles

  4. Universidad de las Américas Puebla, Puebla, Mexico

    Juan Carlos Olivares-Gazca & Mónica D. Salgado-Cabrera

  5. Division of Hematology-Oncology, Mayo Clinic Jacksonville, Jacksonville, FL, 32224, USA

    Mohamed Kharfan-Dabaja

  6. Universidad Autónoma de Nuevo León, Facultad de Medicina y Hospital Universitario “Dr. José Eleuterio González”, Monterrey, Nuevo León, Mexico

    David Gomez-Almaguer & Andrés Gómez-De-León

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  1. Olivia Lira-Lara
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Contributions

OLL was responsible for writing the protocol and report, conducting the search, extracting and analyzing data, interpreting results, creating tables and figures and updating reference lists. MRN contributed to writing the report, extracting and analyzing data and interpreting results. JCOG was responsible for designing the review protocol, analyzing data and interpreting results. MKD was responsible for writing, proofreading the manuscript and grammatical corrections. MRA, DGV, MLC and MDSC contributed to data extraction and collection of bibliographic sources. DGA, AGDL and GJRD contributed to the design of the protocol and proofreading the manuscript. GJRA was responsible for designing research, contributing vital analytical tools, analyzing data and writing paper.

Corresponding author

Correspondence to Guillermo J. Ruiz-Argüelles.

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Competing interests

The authors declare no competing interests.

Ethics approval and consent to participate

All methods were performed in accordance with Helsinki Declaration and national regulations. The protocol was approved by the Institutional Review Board of the Clínica Ruiz (CEI-10-03-24-02). Informed consent was obtained from all participants. The protocol has been registered in ClinicalTrials.govNCT02674217.

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Lira-Lara, O., Robles-Nasta, M., Olivares-Gazca, J.C. et al. Early morbimortality in autologous hematopoietic cell transplantation performed on outpatient basis in patients with autoimmune diseases: experience in 1700 patients. Bone Marrow Transplant 60, 640–644 (2025). https://doi.org/10.1038/s41409-025-02544-y

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