Prolonged remission of longstanding systemic lupus erythematosus after autologous bone marrow transplant for non-Hodgkin's lymphoma

Bone Marrow Transplant. 1997 Jun;19(12):1247-50. doi: 10.1038/sj.bmt.1700815.

Abstract

We describe a patient with longstanding steroid-dependent systemic lupus erythematosus (SLE) in whom clinical and serological remission was achieved following high-dose therapy and autologous bone marrow rescue for high-grade non-Hodgkin's lymphoma. However, 3 years later, autoimmune disease re-presented in the form of immune thrombocytopenia (ITP), which had not previously been a feature of the SLE, necessitating reintroduction of steroid immunosuppression. Relapse of SLE is most likely, although de novo ITP post-BMT is also a possibility. The case suggests that severe long-standing autoimmune disease may be controlled by high-dose therapy and autologous stem cell reconstitution. However, further studies are required to determine the mechanism of re-emergence of autoimmunity and to evaluate optimal regimens and the potential value of such therapy in severe autoimmune diseases.

Publication types

  • Case Reports

MeSH terms

  • Anemia, Hemolytic, Autoimmune / complications
  • Anemia, Hemolytic, Autoimmune / drug therapy
  • Anemia, Hemolytic, Autoimmune / immunology
  • Bone Marrow Transplantation*
  • Female
  • Humans
  • Lupus Erythematosus, Systemic / complications*
  • Lupus Erythematosus, Systemic / immunology
  • Lupus Erythematosus, Systemic / therapy*
  • Lymphoma, B-Cell / complications*
  • Lymphoma, B-Cell / therapy*
  • Middle Aged
  • Steroids / therapeutic use
  • Thrombocytopenia / complications
  • Thrombocytopenia / diagnosis
  • Thrombocytopenia / immunology
  • Time Factors
  • Transplantation, Autologous

Substances

  • Steroids