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Stem cell transplantation for rheumatic autoimmune diseases

Lookup NU author(s): Dr Thomas Huegle, Professor Jaap Van Laar

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Abstract

Immunoablative therapy and hematopoietic stem cell transplantation (HSCT) is an intensive treatment modality aimed at 'resetting' the dysregulated immune system of a patient with immunoablative therapy and allow outgrowth of a nonautogressive immune system from reinfused hematopoietic stem cells, either from the patient (autologous HSCT) or a healthy donor ( allogeneic HSCT). HSCT has been shown to induce profound alterations of the immune system affecting B and T cells, monocytes, and natural killer and dendritic cells, resulting in elimination of autoantibody-producing plasma cells and in induction of regulatory T cells. Most of the available data have been collected through retrospective cohort analyses of autologous HSCT, case series, and translational studies in patients with refractory autoimmune diseases. Long-term and marked improvements of disease activity have been observed, notably in systemic sclerosis, systemic lupus erythematosus, and juvenile idiopathic arthritis, and treatment-related morbidity and mortality have improved due to better patient selection and modifications of transplant regimens. Treatment-related mortality has decreased to approximately 7%. Prospective, randomised, controlled clinical trials are ongoing or planned in systemic sclerosis, systemic lupus erythematosus, and several nonrheumatological conditions.


Publication metadata

Author(s): Hugle T, van Laar JM

Publication type: Article

Publication status: Published

Journal: Arthritis Research & Therapy

Year: 2008

Volume: 10

Issue: 5

Pages: 217

ISSN (print): 1478-6354

ISSN (electronic): 1478-6362

URL: http://dx.doi.org/10.1186/ar2486

DOI: 10.1186/ar2486


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