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.

  • Letter to the Editor
  • Published:

Complete resolution of severe ulcerative colitis after haploidentical hematopoietic stem cell transplantation followed by post-transplant high-dose cyclophosphamide

Bone Marrow Transplantation volume 52, pages 1204–1205 (2017)Cite this article

Subjects

Ulcerative colitis (UC) is an inflammatory bowel disease characterized by a chronic intestinal inflammation due to dysregulated mucosal immune responses. Allogeneic hematopoietic stem cell transplantation (allo-HSCT) can lead to symptomatic improvement in various autoimmune diseases by resetting the immune system.1 There is a growing interest in the utility of allogeneic transplants in refractory inflammatory bowel disease (IBD), including UC.2 However, due to high morbidity and mortality, allo-HSCT is currently not an accepted therapy of choice for severe steroid-refractory UC.

The efficacy of high-dose chemotherapy and pulse doses of cyclophosphamide (Cy) followed by autologous hematopoietic stem cell transplantation (ASCT) in IBD patients is well established.3, 4, 5, 6, 7, 8 The benefit of allo-HSCT from HLA-matched donors in IBD patients, particularly for patients with Crohn’s disease, has also been described.9 However, little information is available about the efficacy of HLA-mismatched allo-HSCT and post post-transplantation Cy in patients with severe UC. Here we present a patient with severe UC who achieved a long-lasting remission after haploidentical HSCT (haplo-HSCT) followed by post-transplantation Cy.

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

Figure 1
Figure 2

References

  1. Wirths S, Bethge W, Henes JC . [Allogeneic stem cell transplantation : An option for autoimmune diseases?]. Z Rheumatol 2016; 75: 780–785.

    Article  CAS  PubMed  Google Scholar 

  2. Ditschkowski M, Einsele H, Schwerdtfeger R, Bunjes D, Trenschel R, Beelen DW et al. Improvement of inflammatory bowel disease after allogeneic stem-cell transplantation. Transplantation 2003; 75: 1745–1747.

    Article  PubMed  Google Scholar 

  3. Barta Z, Toth L, Zeher M . Pulse cyclophosphamide therapy for inflammatory bowel disease. World J Gastroenterol 2006; 12: 1278–1280.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  4. Barta Z, Zold E, Zeher M . Pulse cyclophosphamide in steroid-resistant inflammatory bowel disease. Aliment Pharmacol Ther 2007; 25: 1363–1364.

    Article  CAS  PubMed  Google Scholar 

  5. Kreisel W, Potthoff K, Bertz H, Schmitt-Graeff A, Ruf G, Rasenack J et al. Complete remission of Crohn's disease after high-dose cyclophosphamide and autologous stem cell transplantation. Bone Marrow Transplant 2003; 32: 337–340.

    Article  CAS  PubMed  Google Scholar 

  6. Burt RK, Traynor A, Oyama Y, Craig R . High-dose immune suppression and autologous hematopoietic stem cell transplantation in refractory Crohn disease. Blood 2003; 101: 2064–2066.

    Article  CAS  PubMed  Google Scholar 

  7. Burt RK, Ruiz MA, Kaiser RL Jr . Stem cell transplantation for refractory Crohn disease. JAMA 2016; 315: 2620.

    Article  PubMed  Google Scholar 

  8. Oyama Y, Craig RM, Traynor AE, Quigley K, Statkute L, Halverson A et al. Autologous hematopoietic stem cell transplantation in patients with refractory Crohn's disease. Gastroenterology 2005; 128: 552–563.

    Article  PubMed  Google Scholar 

  9. Al-toma A, Nijeboer P, Bouma G, Visser O, Mulder CJ . Hematopoietic stem cell transplantation for non-malignant gastrointestinal diseases. World J Gastroenterol 2014; 20: 17368–17375.

    Article  PubMed  PubMed Central  Google Scholar 

  10. Nagaishi K, Arimura Y, Fujimiya M . Stem cell therapy for inflammatory bowel disease. J Gastroenterol 2015; 50: 280–286.

    Article  CAS  PubMed  Google Scholar 

  11. Ozgur TT, Asal GT, Cetinkaya D, Orhan D, Kilic SS, Usta Y et al. Hematopoietic stem cell transplantation in a CD3 gamma-deficient infant with inflammatory bowel disease. Pediatr Transplant 2008; 12: 910–913.

    Article  PubMed  Google Scholar 

  12. Rabian F, Porcher R, Sicre de Fontbrune F, Lioure B, Laplace A, Nguyen S et al. Influence of previous inflammatory bowel disease on the outcome of allogeneic hematopoietic stem cell transplantation: a matched-pair analysis. Biol Blood Marrow Transplant 2016; 22: 1721–1724.

    Article  PubMed  Google Scholar 

  13. Showel M, Fuchs EJ . Recent developments in HLA-haploidentical transplantations. Best Pract Res Clin Haematol 2015; 28: 141–146.

    Article  PubMed  PubMed Central  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Division of Hematology and Oncology, College of Medicine, University of Florida, Gainesville, FL, USA

    A Unnikrishnan, J R Wingard & M Norkin

  2. Division of Gastroenterology, Hepatology and Nutrition, University of Florida, Gainesville, FL, USA

    S C Glover & O Norkina

Authors
  1. A Unnikrishnan
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. S C Glover
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. O Norkina
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. J R Wingard
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. M Norkin
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to A Unnikrishnan.

Ethics declarations

Competing interests

The authors declare no conflict of interest.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Unnikrishnan, A., Glover, S., Norkina, O. et al. Complete resolution of severe ulcerative colitis after haploidentical hematopoietic stem cell transplantation followed by post-transplant high-dose cyclophosphamide. Bone Marrow Transplant 52, 1204–1205 (2017). https://doi.org/10.1038/bmt.2017.94

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/bmt.2017.94

Search

Advanced search

Quick links