Transplantation of Hematopoietic Stem Cells in the Treatment of
Autoimmune Diseases in Rheumatology
Kozák T.,
Oddělení klinické hematologie FNKV, Praha 1 Revmatologický ústav, Praha 2 Neurologická klinika VFN, Praha 3 Neurologická klinika FNKV, Praha 4 Ústav hematologie a krevní transfuze, Praha |
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Summary:
Autoimmune diseases (AID) result from the impairment of the effector and/or recognition phase of the immune
response. 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 on
immunosuppression. However, some patients do not respond to its standard doses. The disease becomes intractable
with the survival rate comparable to that of some haematological malignancies, or patients become soon handicapped
with very poor quality of life, depending on continual administration of high doses of steroids. The new hope for
those patients becomes therapy with high dose myelo- and immuno-ablative chemotherapy with autologous
hematopoietic progenitor cell support (PBPC). Tens of patients with intractable forms of AID were transplanted in
the pilot clinical studies with promising results. The most frequent indications included: SLE, SSc, and RA. Final
conclusion of the therapeutic effects will be drawn from the analysis of larger trails.
Key words:
autoimmune diseases, systemic lupus erythematosus, haematological malignancies, myeloablation,
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