New horizons in the treatment of autoimmune diseases: Immunoablation and stem cell transplantation

被引:59
作者
Marmont, AM [1 ]
机构
[1] S Martinos Hosp, Dept Hematol DEMA, I-16132 Genoa, Italy
来源
ANNUAL REVIEW OF MEDICINE | 2000年 / 51卷
关键词
autoimmunity; immunoablation; transplantation; stem cells;
D O I
10.1146/annurev.med.51.1.115
中图分类号
R-3 [医学研究方法]; R3 [基础医学];
学科分类号
1001 ;
摘要
The prevalence of autoimmune diseases (ADs) in Western countries is estimated to be from 3-7%, and the treatment of severe, relapsing/refractory cases is still not satisfactory. The concept of utilizing intense immunosuppression followed by allogeneic or even autologous hemolymphopoietic stem cells (HSCs) to treat AD is based on encouraging results in experimental animals and from serendipitous cases of patients with both ADs and malignancies who were allotransplanted for the latter. However, rare unexpected relapses despite donor immune engraftment have been reported following HSC transplantation for AD. Autologous transplantation is a more feasible procedure with lower toxicity than allogeneic transplantation. This article analyzes the experimental basis for stem cell transplantation in AD and discusses the most important clinical results of both allogeneic and autologous HSC transplants.
引用
收藏
页码:115 / 134
页数:20
相关论文
共 117 条
[71]   Blast crisis of chronic myelogenous leukemia in long lasting systemic lupus erythematosus: Regression of both diseases after autologous bone marrow transplantation [J].
Meloni, G ;
Capria, S ;
Vignetti, M ;
Mandelli, F ;
Modena, V .
BLOOD, 1997, 89 (12) :4659-4659
[72]   'Sustained remission' in a case of SLE following megadose cyclophosphamide [J].
Mittal, G ;
Balakrishna, C ;
Mangat, G ;
Joshi, VR .
LUPUS, 1999, 8 (01) :77-80
[73]   TRANSPLANTATION OF AUTOIMMUNE POTENTIAL .1. DEVELOPMENT OF ANTINUCLEAR ANTIBODIES IN H-2 HISTOCOMPATIBLE RECIPIENTS OF BONE-MARROW FROM NEW-ZEALAND BLACK MICE [J].
MORTON, JI ;
SIEGEL, BV .
PROCEEDINGS OF THE NATIONAL ACADEMY OF SCIENCES OF THE UNITED STATES OF AMERICA, 1974, 71 (06) :2162-2165
[74]   Autologous peripheral blood stem and progenitor (CD34+) cell transplantation for systemic lupus erythematosus complicated by Evans Syndrome [J].
Musso, M ;
Porretto, F ;
Crescimanno, A ;
Bondi, F ;
Polizzi, V ;
Scalone, R ;
Mariani, G .
LUPUS, 1998, 7 (07) :492-494
[75]  
NAPARSTEK E, 1993, BONE MARROW TRANSPL, V12, P185
[76]  
Nelson JL, 1997, J RHEUMATOL, V24, P23
[77]  
Passweg JR, 1999, BONE MARROW TRANSPL, V23, pS35
[78]  
*PRIMS STUD GROUP, 1998, LANCET, V352, P1491
[79]  
Quartier P, 1999, LANCET, V353, P1885, DOI 10.1016/S0140-6736(05)75094-7
[80]   Treatment of severe Evans syndrome with an allogeneic cord blood transplant [J].
Raetz, E ;
Beatty, PG ;
Adams, RH .
BONE MARROW TRANSPLANTATION, 1997, 20 (05) :427-429