PTU-082 Responders to haemopoietic stem cell transplantation for crohn’s disease
Bibliographic record
Abstract
Introduction We recently reported that about one third of patients with Crohn’s disease experience prolonged regression of ileocolonic disease following haemopoietic stem cell transplantation (HSCT). Here we compare the characteristics of responders and non-responders. Method Patients with impaired quality-of-life from active Crohn’s disease not amenable to surgery despite treatment with at least 3 immunosuppressive agents all underwent stem cell mobilisation before randomisation to immuno-ablation followed by unselected cyclophosphamide-based conditioning and HSCT after one month (Early HRCT) or one-year (Delayed HS CT). Patients in whom all endoscopic evidence of Crohn’s disease disappeared (SES-CD score of zero) were classified as Responders. Supporting histology was available in 17 of them. Results Forty four patients with ileocolonic involvement underwent mobilisation before randomisation to Early or Delayed HSCT. Of 38 patients that could be classified 14 were Responders. Ten had SES-CD of zero after 1 year, (maintained in the second in 3 of 4 with available data) and 4 achieved responder status in year 2. Four of 6 followed to 4 years remain free of Crohn’s disease vs 1 of 15 non-responders. Responders were significantly more likely to have histologically normal segments post HSCT (Table 1) A Responder status tended to be more likely with no family history (39% vs 20%), in non-smokers (54% vs 30%), with early-onset of disease (Montreal A1, 46% vs 32%)) and with more than 10 year history (46% vs 17%); those with pure colonic involvement (L2) were less likely to respond than those with ileal involvement (L1, L3, 14% vs 43%) but these fell short of statistical significance on univariate analysis. Conclusion A group of patients can be identified who have a substantial and long lasting regression of Crohn’s disease following HSCT. Endoscopic response following HSCT is associated with regression of histological evidence of Crohn’s disease. Disclosure of interest None Declared.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.006 | 0.002 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".