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Hematopoietic stem cell transplantation in autoimmune disease. Volume 13, issue 6, Novembre-Décembre 2007

Authors
Département d’hématologie et oncologie médicale, Hôtel-Dieu, Paris, Service de médecine interne, Hôpital Saint-Louis, Paris, INSERM U697, Hôpital Saint-Louis, Paris

Experimental considerations and clinical experience suggest that high doses immunoablation followed by hematopoietic stem cell transplantation (HSCT) is a therapeutic option to consider for certain severe autoimmune disorders. Patient selection has been recognized as a crucial element from the phase I-II trials. Improved safety of both autologous and allogeneic HSCT over the last decade has been followed by increasing acceptance of HSCT as an experimental treatment for severe autoimmune diseases that are resistant to conventional treatment. Prospective randomized studies are in progress and should now determine the value of HSCT compared to standard therapy. This review provides the update on the efficacy and toxicity of HSCT in severe autoimmune disease.