Changes in Scleroderma After SCOT Treatment

The photographs on the top right are of serial skin biopsies taken from a single patient with scleroderma. Under the microscope, fibrosis, which causes the hardening of the skin, is seen as dense pink material (collagen). Before treatment (top photos A and B) dense collagen deposits, in the skin are very prominent. One year after treatment (middle photos C and D), the fibrosis has improved and five years after treatment the fibrosis is no longer thick and skin is normal (bottom photos E and F). Low power (5x) views are on the left (A, C and E) and high power (20x) microscope views are on the right (B, D and F).

The graph on the lower right displays the improvement of the hardening of the skin in people with scleroderma after stem cell transplant. The Rodnan skin score, a measurement of skin hardening in scleroderma, is plotted on the vertical axis and years after treatment is shown on the horizontal axis. Normal skin is given a score of 0. The higher the Rodnan score, the worse the skin hardening. Individual patient measurements are shown by thin gray lines and the solid black line represents the average of all of these patients with scleroderma. Over time, there is significant and continuing improvement of the skin toward normal in people with scleroderma after this therapy.

These results are from high-dose immune suppressive treatment and blood stem cell transplantation. This represents one treatment arm of the SCOT (Scleroderma: Cyclophosphamide or Transplantation) treatment clinical trial. Although these results relate to the transplant part of the trial, the other arm (high dose cyclophosphamide) has also given similarly promising results.

For further information, call toll free 866-909-SCOT (7268) or see the Web site www.sclerodermatrial.org.