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Improved outcome of HSCT in STAT1 gain-of-function disease following JAK inhibition bridging

  • Emilie Pauline Buddingh*
  • , Mary Slatter
  • , Juan Carlos Aldave Becerra
  • , Laura Alonso Garcia
  • , Erik von Asmuth
  • , Safa Baris
  • , Oscar de la Calle-Martín
  • , Alice Y. Chan
  • , Su Wan Bianca Chan
  • , Shanmuganathan Chandrakasan
  • , Deepakbabu Chellapandian
  • , Jasmeen Dara
  • , Susan Farmand
  • , Anders Fasth
  • , Lisa Forbes Satter
  • , Renata Formankova
  • , Eyal Grunebaum
  • , Steven J. Keogh
  • , Ayça Kiykim
  • , Jörn Sven Kühl
  • Alexandra Laberko, Timothy Ronan Leahy, Caroline Lindemans, Carad Martinez, Laura Martínez-Martínez, William Glenn Mitchell, Emma Morris, Joseph H. Oved, Maria Polacik, Jacques G. Rivière, Chaim M. Roifman, Sara Sebnem Kilic, Petr Sedlacek, Ami J. Shah, Linda Vong, Arjan C. Lankester, Michael H. Albert, Bénédicte Neven, Troy Torgerson, Jennifer Leiding, Catharina Schuetz*,
*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

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Abstract

Germline gain-of-function (GOF) mutations in signal transducer and activator of transcription 1 (STAT1) are associated with infections, including chronic mucocutaneous candidiasis and autoimmunity. Morbidity is high, and disease manifestations can be life-threatening. Curative allogeneic hematopoietic stem cell transplantation (HSCT) historically has had poor outcomes. We identified 36 patients with STAT1 GOF disease, receiving 40 HSCT procedures in 2010–2023, in a combined effort of the EBMT-IEWP and the PIDTC. Median age at first transplant was 11 years (range 1–33). Indications for HSCT were combined immunodeficiency, severe and/or refractory infections, and autoimmunity. Acute GvHD occurred in 22/40 HSCT procedures; 5 patients suffered from grade III/IV acute GvHD. One patient had chronic GvHD. Overall survival was 72.2%, and event-free survival was 55.6%, markedly improved from an earlier report on HSCT for STAT1 GOF disease. Patients with an HCT-CI score of 1 or higher had worse outcome. Pre-treatment with Janus kinase (JAK) inhibitors was associated with better event-free survival.

Original languageEnglish
Article numbere20250027
JournalJournal of human immunity
Volume1
Issue number3
DOIs
Publication statusPublished - 1 Sept 2025

Keywords

  • Inborn errors of immunity
  • Severe immunodeficiencies
  • Therapeutics

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