Hematopoietic stem cell therapy for autoimmune diseases - Clinical experience and mechanisms

J Autoimmun. 2018 Aug;92:35-46. doi: 10.1016/j.jaut.2018.06.002. Epub 2018 Jun 20.

Abstract

With accumulating evidence and improved outcomes along with recognition that modern biological therapies are not universally effective, require chronic administration and have high acquisition costs, hematopoietic stem cell transplantation (HSCT) has become an emerging direction for cell therapy in autoimmune diseases (ADs). The goal of this therapy is to induce medication-free remissions by resetting the immune system into a naïve and self-tolerant state through eradication of the autoreactive immunologic memory and profound re-configuration of the immune system induced by the transplant procedure. Safety of HSCT has generally improved by implementing internal quality management and external accreditation. Inter-disciplinary guidelines for patient selection, transplant technique and supportive care along with greater center experience should optimize safe and appropriate delivery of HSCT in specific ADs. In this review, we discuss the current role and future perspectives of HSCT in AD, focusing on recent published clinical and scientific studies and recommendations in the field.

Keywords: Autoimmune diseases; Autoimmunity; Cell therapy; HSCT; Stem cell transplantation.

Publication types

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

MeSH terms

  • Animals
  • Autoimmune Diseases / therapy*
  • Clonal Anergy
  • Clonal Selection, Antigen-Mediated
  • Hematopoietic Stem Cell Transplantation*
  • Hematopoietic Stem Cells / physiology*
  • Humans
  • Immune System*
  • Immune Tolerance
  • Patient Selection