Autologous marrow stem cell transplantation for severe systemic lupus erythematosus of long duration

A 46 year woman with severe long-lasting SLE received an autologous bone marrow transplantation utilising CD34(+) haematopoietic progenitors following a 3 log T-lymphocyte depletion. The immunosuppressive regimen (conditioning) consisted of 15 mg/kg Thiotepa followed by 100 mg/kg of cyclophosphamide over 2 d. Granulocytic recovery was aided by G-CSF. The post-transplant course was uneventful, and a good clinical and immunologic remission (ANA negativisation) was achieved. This is the first case of SLE having received an autologous progenitor cell transplant for the autoimmune disease by itself, unaccompanied by a haematologic condition requiring transplantation. The potential, advantages and limits of this procedure, which are currently being explored worldwide, are briefly discussed.