BONE MARROW TRANSPLANTATION IN AUTOIMMUNE DISEAS

Key words: Autoimmune diseases, Chronic arthritis, Stem cell transplantation

We report the results of a series of autologous stem cell transplants in autoimmune diseases. The stem cells were treated ex vivo with vincristine and methylprednisolone as previously in allogeneic mismatched transplants in advanced leukemia. The conditioning regimen was: cyclophosphamide and antilymphocytic serum (+AraC in multiple sclerosis). The outcome was very good in 2 over 3 patients with scleroderma secondary to chronic GVHD (1 relapsed after 6 months), in 3 juvenile chronic arthritis, in 1 myasthenia gravis, 1 multiple sclerosis, 1 pure red cell aplasia (relapsed 5 months later); 1 patient with autoimmune enteropathy had only laboratory improvements (absorption, biopsy). 1 patient with systemic vasculitis and 1 with SLE in CLL seem improving after a short follow up. The patients did not suffer from major untoward effects and were discharged after 10 days in treatment with cyclosporin and cortison (progressively withdrawn).