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Early recurrence or persistence of autoimmune diseases after unmanipulated
autologous stem cell transplantation
HH Euler, AM Marmont, A Bacigalupo, S Fastenrath, P Dreger, M Hoffknecht, AR Zander, B Schalke, U Hahn, R Haas and N Schmitz
Department of Internal Medicine II, Christian Albrechts University, Kiel,
Germany.
Autologous stem cell transplantation with or without in vitro lymphocyte
depletion has been suggested as a new treatment option for severe
autoimmune diseases. We describe five patients with autoimmune diseases
(CREST syndrome, myasthenia gravis and Hashimoto's thyroiditis, systemic
lupus erythematosus, atopic dermatitis, and rheumatoid arthritis) who
underwent autologous bone marrow (n = 1) or peripheral blood progenitor
cell (n = 4) transplantation with unmanipulated grafts as treatment for the
autoimmune disease in one case or as treatment for a malignant disorder
with a concomitant autoimmune disorder in four cases. In all patients
serological and clinical signs of the autoimmune disease recurred early or
persisted. These observations should be regarded as a cautionary note
concerning the efficacy of high-dose therapy followed by transplantation of
unmanipulated autologous stem cells for treatment of severe autoimmune
diseases.
Volume 88,
Issue 9,
pp. 3621-3625,
11/01/1996
Copyright © 1996 by The American Society of Hematology
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