Hemopoietic stem cell transplantation in rheumatic diseases--an update.

Abstract:

:Hematopoietic stem cell transplant (HSCT) for autoimmune diseases has been recognized as a potential treatment for patients who have failed conventional therapy. Autologous (self) donor cells have been preferred over allogeneic (HLA-matched) cells for rescue after high dose immunotherapy, given the previous higher rates of mortality, graft versus host disease (GVHD), and the need for more intense myeloablation associated with the latter. The European Group for bone Marrow Transplantation in Basel Switzerland (EBMT) and various groups within the US funded by the NIH (including the Autologous Blood and Marrow Transplant Registry (ABMTR)) have been pivotal in maintaining registries on patients transplanted as well as promoting homogeneity for future studies including Rheumatoid Arthritis (RA), Systemic Lupus Erythematosus (SLE) and Systemic Sclerosis (SSc). Although, patients transplanted for RA show initial success, relapse of the disease is common. In many, however, a second positive result can be obtained with the addition of DMARD therapy to which they were previously unresponsive, suggesting a "debulking" of disease by HSCT. SLE patients also have a high rate of success after HSCT, although current mortality rates appear high. Transplant in SSc patients has offered durable responses with improving transplant-related mortality related to careful patient selection.

journal_name

Autoimmun Rev

journal_title

Autoimmunity reviews

authors

de Buys P,Khanna D,Furst DE

doi

10.1016/j.autrev.2005.03.003

keywords:

subject

Has Abstract

pub_date

2005-09-01 00:00:00

pages

442-9

issue

7

eissn

1568-9972

issn

1873-0183

pii

S1568-9972(05)00039-X

journal_volume

4

pub_type

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