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Hematopoietic stem cell transplantation for autoimmune disorders
J Passweg1, A Gratwohl, A Tyndall
1Division of Hematology, Kantonsspital Basel, Switzerland. passweg@ubaclu.unibas.ch
Current Opinion in Hematology
|November 5, 1999
Summary
Autologous hematopoietic stem cell transplantation (HSCT) shows promise for autoimmune diseases, with some patients experiencing dramatic responses. However, failures, relapses, and complications necessitate further research to determine long-term benefits and patient selection.
Area of Science:
- Immunology
- Hematology
- Transplantation Medicine
Background:
- Autologous hematopoietic stem cell transplantation (HSCT) is increasingly explored for autoimmune diseases.
- Insights are drawn from animal models and HSCT in malignancy patients.
Purpose of the Study:
- To review early studies and case reports of HSCT in various autoimmune conditions.
- To assess the efficacy and safety of HSCT for autoimmune diseases.
Main Methods:
- Review of early phase II studies and case reports.
- Analysis of patient outcomes in multiple sclerosis, systemic sclerosis, lupus erythematosus, rheumatoid arthritis, juvenile chronic arthritis, and idiopathic thrombocytopenic purpura.
Main Results:
- Observed dramatic responses or disease stabilization in some patients.
- Reported failures, disease relapses, toxicities, and infectious complications in others.
Conclusions:
- HSCT shows variable outcomes for autoimmune diseases.
- Further investigation is required to determine if HSCT induces peripheral immunologic tolerance and identify long-term beneficiaries.