Outcome of rheumatoid arthritis and psoriasis following autologous stem cell transplantation for hematologic malignancy.
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.
Cooley
H M
HM
Royal Melbourne Hospital, Victoria, Australia.
Snowden
J A
JA
Grigg
A P
AP
Wicks
I P
IP
D000328:Adult; D001172:Arthritis, Rheumatoid / Q000150:complications / Q000503:physiopathology / Q000628:therapy*; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D007938:Leukemia / Q000150:complications / Q000628:therapy*; D008223:Lymphoma / Q000150:complications / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D011565:Psoriasis / Q000150:complications / Q000503:physiopathology / Q000628:therapy*; D012008:Recurrence; D012074:Remission Induction