Outcome of rheumatoid arthritis and psoriasis following autologous stem cell transplantation for hematologic malignancy

Arthritis Rheum. 1997 Sep;40(9):1712-5. doi: 10.1002/art.1780400923.

Abstract

Based on successful results in animal models, it has been proposed that high-dose myeloablative therapy followed by autologous bone marrow or stem cell transplantation (ABMT/ASCT) may cure autoimmune disease. The coexistence of autoimmune disease and hematologic malignancy provides an opportunity to examine the response of autoimmune disease to ABMT or ASCT. We describe 4 patients with autoimmune disease (3 with psoriasis and 1 with rheumatoid arthritis) and hematologic malignancy. In each patient, the autoimmune disease remitted posttransplantation, but, in 4 patients with long-term followup, it recurred at 8-24 months. The earliest relapse occurred in a patient treated with interferon-alpha. Our experience suggests that a single autograft with unpurged stem cells is unlikely to cure autoimmune disease, but that other strategies building on this approach are worthy of investigation.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Arthritis, Rheumatoid / complications
  • Arthritis, Rheumatoid / physiopathology
  • Arthritis, Rheumatoid / therapy*
  • Female
  • Hematopoietic Stem Cell Transplantation*
  • Humans
  • Leukemia / complications
  • Leukemia / therapy*
  • Lymphoma / complications
  • Lymphoma / therapy*
  • Male
  • Middle Aged
  • Psoriasis / complications
  • Psoriasis / physiopathology
  • Psoriasis / therapy*
  • Recurrence
  • Remission Induction