Transplantation of Hematopoietic Stem Cells in the Treatment ofAutoimmune Diseases in Rheumatology

Overview

Autoimmune diseases (AID) result from the impairment of the effector and/or recognition phase of the immuneresponse. The autoimmune process plays a crucial role in the pathogenesis of the systemic lupus erythematosus(SLE), systemic sclerosis (SSc), rheumatoid arthritis (RA), and their treatment is therefore largely based onimmunosuppression. However, some patients do not respond to its standard doses. The disease becomes intractablewith the survival rate comparable to that of some haematological malignancies, or patients become soon handicappedwith very poor quality of life, depending on continual administration of high doses of steroids. The new hope forthose patients becomes therapy with high dose myelo- and immuno-ablative chemotherapy with autologoushematopoietic progenitor cell support (PBPC). Tens of patients with intractable forms of AID were transplanted inthe pilot clinical studies with promising results. The most frequent indications included: SLE, SSc, and RA. Finalconclusion of the therapeutic effects will be drawn from the analysis of larger trails.

Key words:
autoimmune diseases, systemic lupus erythematosus, haematological malignancies, myeloablation,