title: Early recurrence of rheumatoid arthritis after nonmyeloablative allogeneic blood stem cell transplantation in a patient with multiple myeloma.
abstract: Allogeneic blood stem cell transplantation with reduced conditioning has been proposed as a new, potentially curative treatment option for patients with rheumatoid arthritis (RA). We report a 60-year-old woman with RA and coexisting multiple myeloma who was treated with high-dose melphalan and autologous blood stem cell transplantation (BSCT) followed by a nonmyeloablative allogeneic BSCT from her healthy dizygotic twin brother. She achieved a complete remission of her RA after autologous BSCT, but relapsed early despite complete donor chimerism following successful allogeneic transplantation with reduced intensity conditioning. This case illustrates that allogeneic BSCT following nonmyeloablative conditioning may be an uncertain option for curing patients with RA.
authors.affiliation: Department of Hematology, Oncology and Clinical Immunology, Heinrich Heine University Duesseldorf, Düesseldorf, Germany. tapprich@hotmail.com
authors.forename: C
authors.initials: C
authors.lastname: Tapprich
authors.forename: R
authors.initials: R
authors.lastname: Fenk
authors.forename: P
authors.initials: P
authors.lastname: Schneider
authors.forename: A
authors.initials: A
authors.lastname: Bernhardt
authors.forename: R
authors.initials: R
authors.lastname: Haas
authors.forename: G
authors.initials: G
authors.lastname: Kobbe
mesh_terms: D001172:Arthritis, Rheumatoid / Q000150:complications / Q000628:therapy*; D005260:Female; D006801:Humans; D008558:Melphalan / Q000627:therapeutic use; D008875:Middle Aged; D009101:Multiple Myeloma / Q000150:complications* / Q000628:therapy*; D036102:Peripheral Blood Stem Cell Transplantation / Q000379:methods*; D012008:Recurrence; D019172:Transplantation Conditioning / Q000379:methods*; D014182:Transplantation, Autologous; D014184:Transplantation, Homologous; D017211:Treatment Failure
chemical_list: D008558:Melphalan