[Autologous and allogeneic stem cell transplantation for severe autoimmune diseases]

Based on data from preclinical studies and anecdotal case reports in patients with co-existent autoimmune diseases, stem cell transplantation, mainly autologous transplantation, has been performed for patients with severs autoimmune diseases since the past decade. Initial results are encouraging despite controversies. In diseases, such as systemic lupus erythematosus, multiple sclerosis, rheumatoid arthritis, and scleroderma, phase III trails are being designed. Careful selection of patients, mobilization regimens, graft manipulations, and conditioning regimens is the key in order to improve the outcome and avoid the toxicity. Allogeneic transplantation, on the other hand, is still in the initial stage of clinical study, but may be more effective in some diseases that are refractory to immunosuppressive therapies. Ongoing and future trials will prove the value of these approaches.