Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Perspective
  • Published:

Stem cell transplantation for treatment of severe autoimmune diseases: current status and future perspectives

Bone Marrow Transplantation volume 25, pages 351–356 (2000)Cite this article

Abstract

Autoimmune diseases include a heterogenous group of disorders with variable presentation and severity. Immunosuppressive and immunomodulatory therapies are often used for treatment with considerable success in some cases. These diseases may also be severe and refractory to conventional treatment. Thus more aggressive intervention might be indicated in a subset of patients. Animal studies suggest that high-dose therapy supported by stem cell transplantation may lead to remissions in experimental autoimmune disease models. Anecdotal case reports suggest that the same may be the case in some human autoimmune diseases as well. This review attempts to summarise some current concepts and future perspectives on stem cell transplantation in the treatment of severe autoimmune diseases. Bone Marrow Transplantation (2000) 25, 351–356.

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

Similar content being viewed by others

References

  1. Brooks PM, Atkinson K, Hamilton JA . Stem cell transplantation in autoimmune diseases J Rheumatol 1995 22: 1809–1810

    CAS  PubMed  Google Scholar 

  2. Marmont AM, van Bekkum DW . Stem cell transplantation for severe autoimmune diseases: new proposals but still unanswered questions Bone Marrow Transplant 1995 16: 497–498

    CAS  PubMed  Google Scholar 

  3. Marmont A . Tyndall A, Gratwohl A, Vischer T. Haemopoietic precursor-cell transplants for autoimmune diseases Lancet 1995 345: 978

    Article  Google Scholar 

  4. Tyndall A, Gratwohl A . Blood and marrow stem cell transplants in autoimmune diseases: a consensus report written on the behalf of the European League Against Rheumatism (EULAR) and the European Group for Blood and Marrow Transplantation (EBMT) Bone Marrow Transplant 1997 19: 643–645

    Article  CAS  PubMed  Google Scholar 

  5. Burt RK . BMT for severe autoimmune diseases: an idea whose time has come Oncology 1997 11: 1001–1017

    CAS  PubMed  Google Scholar 

  6. Snowden JA, Brooks PM, Biggs JC . Haemopoietic stem cell transplantation for autoimmune diseases Br J Haematol 1997 99: 9–22

    Article  CAS  PubMed  Google Scholar 

  7. Jantunen EJ, Myllykangas-Luosujärvi RA . Stem cell transplantation – a treatment for severe rheumatic diseases? Scand J Rheumatol 1999 28: 69–74

    Article  CAS  PubMed  Google Scholar 

  8. Karussis DM, Vaurka-Karussis U, Lehman D et al. Prevention and reversal of adoptively transferred, chronic relapsing experimental autoimmune encephalomyelitis with a single high dose cytoreductive treatment followed by syngeneic bone marrow transplantation J Clin Invest 1993 92: 765–772

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  9. van Gelder M, Kinvel-Bohre EPM, van Bekkum DW . Treatment of experimental allergic encephalomyelitis in rats with total body irradiation and syngeneic BMT Bone Marrow Transplant 1993 11: 233–241

    CAS  PubMed  Google Scholar 

  10. van Bekkum DW, Bohre EBM, Houben PFJ, Knaan-Shanzer S . Regression of adjuvant-induced arthritis in rats following bone marrow transplantation Proc Natl Acad Sci USA 1989 86: 10090–10096

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  11. Ikehara S, Yasumizu R, Inaba M, et al. Long-term observations of autoimmune-prone mice treated for autoimmune disease by allogeneic bone marrow transplantation Proc Natl Acad Sci USA 1989 86: 3306–3310

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  12. Levite M, Zinger H, Zisman E et al. Beneficial effects of bone marrow transplantation on the serological manifestations and kidney pathology of experimental systemic lupus erythematosus Cell Immunol 1995 162: 138–145

    Article  CAS  PubMed  Google Scholar 

  13. van Bekkum DW . BMT in experimental autoimmune diseases Bone Marrow Transplant 1993 11: 183–187

    CAS  PubMed  Google Scholar 

  14. Good RA, Ikehara S . Preclinical investigations that subserve efforts to employ bone marrow transplantation for rheumatoid or autoimmune diseases J Rheumatol 1997 24: (Suppl.48) 5–12

    Google Scholar 

  15. Jacobs P, Vincent MD, Martell RW . Prolonged remission of severe refractory rheumatoid arthritis following allogeneic bone marrow transplantation for drug-induced aplastic anaemia Bone Marrow Transplant 1986 1: 237–239

    CAS  PubMed  Google Scholar 

  16. Lowenthal RM, Cohen ML, Atkinson K, Biggs JC . Apparent cure of rheumatoid arthritis by bone marrow transplantation J Rheumatol 1993 20: 137–140

    CAS  PubMed  Google Scholar 

  17. McAllister LD, Beatty PG, Rose J . Allogeneic bone marrow transplantation for chronic myelogenous leukemia in a patient with multiple sclerosis Bone Marrow Transplant 1997 19: 395–397

    Article  CAS  PubMed  Google Scholar 

  18. Liu Yin LA, Jowitt SN . Resolution of immune-mediated diseases following allogeneic bone marrow transplantation for leukaemia Bone Marrow Transplant 1992 9: 31–33

    Google Scholar 

  19. Kashyap A, Forman SJ . Autologous bone marrow transplantation for non-Hodgkin's lymphoma resulting in long-term remission in coincidental Crohn's disease Br J Haematol 1998 103: 651–652

    Article  CAS  PubMed  Google Scholar 

  20. Castro J, Bentch HL, Smith L et al. Prolonged clinical remission in patients (pts) with inflammatory bowel disease (IBD) after high dose chemotherapy (HDC) and autologous blood stem cell transplantation Blood 1996 88: (Suppl.1) 133a (Abstr.)

    Google Scholar 

  21. Cooley HM, Snowden JA, Grigg AP, Wicks IP . Outcome of rheumatoid arthritis and psoriasis following autologous stem cell transplantation for hematologic malignancy Arthritis Rheum 1997 40: 1712–1715

    Article  CAS  PubMed  Google Scholar 

  22. Jondeau K, Job-Deslandre C, Bouscary D et al. Remission of non-erosive polyarthritis associated with Sjögren's syndrome after autologous hematopoietic stem cell transplantation for lymphoma J Rheumatol 1997 24: 2466–2468

    CAS  PubMed  Google Scholar 

  23. Snowden JA, Patton WN, O'Donnell JL et al. Prolonged remission of longstanding systemic lupus erythematosus following autologous bone marrow transplantation for non-Hodgkin's lymphoma Bone Marrow Transplant 1997 19: 1247–1250

    Article  CAS  PubMed  Google Scholar 

  24. Meloni G, Capria S, Vignetti M et al. Blast crisis of chronic myelogenous leukemia in long-lasting systemic lupus erythematosus: regression of both diseases after autologous bone marrow transplantation Blood 1997 89: 4659

    CAS  PubMed  Google Scholar 

  25. Rösler W, Mangar B, Repp R et al. Autologous PBSCT in a patient with lymphoma and Sjögren's syndrome: complete remission of lymphoma without control of the autoimmune disease Bone Marrow Transplant 1998 22: 211–213

    Article  PubMed  Google Scholar 

  26. Euler HH, Marmont AM, Bacigalupo A et al. Early recurrence or persistence of autoimmune diseases after unmanipulated autologous stem cell transplantation Blood 1996 88: 3621–3625

    CAS  PubMed  Google Scholar 

  27. Passweg J, Tyndall A on behalf of the International Autoimmune Disease Stem Cell Project, the EBMT Working Party for Autoimmune Disease and the European League Against Rheumatism . Autologous stem cell transplantation for autoimmune diseases Bone Marrow Transplant 1999 23: (Suppl.1) S35 (Abstr.)

    Article  Google Scholar 

  28. Tyndall A, Black C, Finke J et al. Treatment of systemic sclerosis with autologous haemopoietic stem cell transplantation Lancet 1997 349: 254

    Article  CAS  PubMed  Google Scholar 

  29. Martini A, Maccario R, Ravelli A et al. Marked and sustained improvement two years after autologous stem cell transplantation in a girl with systemic sclerosis Arthritis Rheum 1999 42: 807–811

    Article  CAS  PubMed  Google Scholar 

  30. Herbert LV, Wilson H, Lowdell M et al. Peripheral blood stem cell transplantation for the treatment of diffuse systemic sclerosis. Haemopoietic stem cell therapy in autoimmune diseases, Basel, Switzerland, Oct 8–10, 1998 (Abstr.)

  31. Snowden JA, Biggs JC, Milliken ST et al. A phase I/II dose escalation study of intensified cyclophosphamide and autologous blood stem cell rescue in severe, active rheumatoid arthritis Arthritis Rheum 1999 42: 2286–2292

    Article  CAS  PubMed  Google Scholar 

  32. Joske DLJ . Autologous bone marrow transplantation for rheumatoid arthritis Lancet 1997 350: 337–338

    Article  CAS  PubMed  Google Scholar 

  33. Durez P, Toungouz M, Schandene L et al. Remission and immune reconstitution after T-cell-depleted stem cell transplantation for rheumatoid arthritis Lancet 1998 352: 881

    Article  CAS  PubMed  Google Scholar 

  34. Burt RK, Traynor A, Ramsey-Goldman R . Hematopoietic stem-cell transplantation for systemic lupus erythematosus New Engl J Med 1997 337: 1777–1778

    Article  CAS  PubMed  Google Scholar 

  35. Marmont AM, van Lint MT, Gualandi F, Bacigalupo A . Autologous marrow stem cell transplantation for severe systemic lupus erythematosus of long duration Lupus 1997 6: 545–548

    Article  CAS  PubMed  Google Scholar 

  36. Wulffraat N, van Royen A, Bierings M et al. Autologous haemopoietic stem cell transplantation in four patients with refractory juvenile arthritis Lancet 1999 353: 550–553

    Article  CAS  PubMed  Google Scholar 

  37. Fassas A, Agnastopoulos A, Kazis A et al. Peripheral blood stem cell transplantation in the treatment of progressive multiple sclerosis: first results of a pilot study Bone Marrow Transplant 1997 20: 631–638

    Article  CAS  PubMed  Google Scholar 

  38. Burt RK, Traynor AE, Pope R et al. Treatment of autoimmune disease by intense immunosuppressive conditioning and autologous hematopoietic stem cell transplantation Blood 1998 92: 3505–3514

    CAS  PubMed  Google Scholar 

  39. Burt RK, Traynor AE, Cohen B et al. T cell-depleted autologous hematopoietic stem cell transplantation for multiple sclerosis: report on the first three patients Bone Marrow Transplant 1998 21: 537–541

    Article  CAS  PubMed  Google Scholar 

  40. Lim SH, Kell J, Al-Sabah A et al. Peripheral blood stem-cell transplantation for refractory autoimmune thrombocytopenic purpura Lancet 1997 349: 475–476

    Article  CAS  PubMed  Google Scholar 

  41. Skoda RC, Tichelli A, Tyndall A et al. Autologous peripheral blood stem cell transplantation in a patient with chronic autoimmune thrombocytopenia Br J Haematol 1997 99: 56–57

    Article  CAS  PubMed  Google Scholar 

  42. Marmont AM, van Lint MT, Occhini D et al. Failure of autologous stem cell transplantation in refractory thrombocytopenic purpura Bone Marrow Transplant 1998 22: 827–828

    Article  CAS  PubMed  Google Scholar 

  43. Gratwohl A, Passweg J, Baldomero H, Hermans J for the European Group for Blood and Marrow Transplantation (EBMT) . Blood and marrow transplantation activity in Europe 1996 Bone Marrow Transplant 1998 22: 227–240

    Article  CAS  PubMed  Google Scholar 

  44. Schmitz N, Linch DC, Dreger P et al. Randomised trial of filgrastim-mobilised peripheral blood progenitor cell transplantation versus autologous bone marrow transplantation in lymphoma patients Lancet 1996 347: 353–357

    Article  CAS  PubMed  Google Scholar 

  45. Mills KC, Gross TG, Varney ML et al. Immunologic phenotype and function in human bone marrow, blood stem cells and umbilical cord blood Bone Marrow Transplant 1996 18: 53–61

    CAS  PubMed  Google Scholar 

  46. Roberts MM, To LB, Gillis D et al. Immune reconstitution following peripheral blood stem cell transplantation, autologous bone marrow transplantation and allogeneic bone marrow transplantation Bone Marrow Transplant 1993 12: 469–475

    CAS  PubMed  Google Scholar 

  47. Vidarsson B, Geirsson AJ, Önundarson PT . Reactivation of rheumatoid arthritis and development of leukocytoclastic vasculitis in a patient receiving granulocyte colony-stimulating factor for Felty's syndrome Am J Med 1995 98: 589–591

    Article  CAS  PubMed  Google Scholar 

  48. McGonagle D, Rawstron A, Richards S et al. A phase I study to address the safety and efficacy of granulocyte colony-stimulating factor for the mobilization of hematopoietic progenitor cells in active rheumatoid arthritis Arthritis Rheum 1997 40: 1838–1842

    Article  CAS  PubMed  Google Scholar 

  49. Snowden JA, Biggs JC, Milliken ST et al. A randomised, blinded, placebo-controlled, dose escalation study of the tolerability and efficacy of filgrastim for haemopoietic stem cell mobilization in patients with severe active rheumatoid arthritis Bone Marrow Transplant 1998 22: 1035–1041

    Article  CAS  PubMed  Google Scholar 

  50. Brodsky RA, Petri M, Smith DB et al. Immunoablative high-dose cyclophosphamide without stem cell rescue for refractory severe autoimmune disease Ann Intern Med 1998 129: 1031–1035

    Article  CAS  PubMed  Google Scholar 

  51. Miller JC, Arthur DC, Litz CE et al. Myelodysplastic syndrome after autologous bone marrow transplantation: an additional late complication of curative cancer therapy Blood 1994 83: 3780–3786

    CAS  PubMed  Google Scholar 

  52. Milligan DW, Ruiz de Elvira C, Taghipour C et al. MDS and secondary leukaemia after autografting for lymphoma: a final report from the EBMT registry Bone Marrow Transplant 1997 19: (Suppl.1) S209 (Abstr.)

    Article  Google Scholar 

  53. Ikehara S, Kawamura M, Takao F et al. Organ-specific and systemic autoimmune diseases originate from defects in hematopoietic stem cells Proc Natl Acad Sci USA 1990 87: 8341–8344

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  54. Slavin S, Nagler A, Naparstek E et al. Nonmyeloablative stem cell transplantation and cell therapy as an alternative to conventional bone marrow transplantation with lethal cytoreduction for the treatment of malignant and nonmalignant hematologic diseases Blood 1998 91: 756–763

    CAS  PubMed  Google Scholar 

  55. Emmons RVB, Quesenberry PJ . Stem cell transplantation for reinduction of self-tolerance in autoimmune disease Curr Opin Organ Transplant 1999 4: 197–201

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Medicine, Kuopio University Hospital, Kuopio, Finland

    E Jantunen & R Myllykangas-Luosujärvi

Authors
  1. E Jantunen
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. R Myllykangas-Luosujärvi
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Jantunen, E., Myllykangas-Luosujärvi, R. Stem cell transplantation for treatment of severe autoimmune diseases: current status and future perspectives. Bone Marrow Transplant 25, 351–356 (2000). https://doi.org/10.1038/sj.bmt.1702152

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/sj.bmt.1702152

Keywords

This article is cited by

Search

Advanced search

Quick links