[A preliminary study on the treatment of severe autoimmune disease by autologous peripheral CD(34)(+) cell transplantation].
OBJECTIVE
To evaluate the feasibility of autologous peripheral CD(34)(+) cell transplantation for the treatment of severe autoimmune disease.


METHODS
Ten patients received mobilized and purified CD(34)(+) cells transplantation. The mobilization regimen was CTX plus rhG-CSF and the CD(34)(+) cells were selected by CliniMACS. (1.98 +/- 0.95) x 10(8) CD(34)(+) cells were obtained. The purity of CD(34)(+) cells was (91.4 +/- 10.6)% and the recovering rate was (60.5 +/- 19.8)%. The conditioning regimens were CTX (200 mg/kg) plus ATG (90 mg/kg) or CTX (150 mg/kg) plus TBI (4 - 6 Gy). (2.14 +/- 1.05) x 10(6)/kg CD(34)(+) cells were infused. The time of ANC >or= 0.5 x 10(9)/L was 8.6 +/- 2.5 days, and platelet >or= 20 x 10(9)/L was 9.0 +/- 5.2 days. After the hematopoietic recovery, the levels of CD(3)(+) T cell, CD(19)(+) B cells and CD(16)(+)CD(56)(+) NK cells were all below that of pre-transplantation. The main transplant-related complication was CMV infection. The transplant-related mortality was 2/10. All patients who survived showed improvement of the disease with DAI score decreasing from 17 to 4 in systemic lupus erythematosus patients, DAS 28 score from 6.4 to 1.8 in rheumatoid arthritis patients.


CONCLUSIONS
The result suggests that autologous peripheral CD(34)(+) cell transplantation is an alternative choice for the treatment of severe autoimmune disease. The short-term outcome is satisfying.
Zhou
Dao-bin
DB
Department of Hematology, Peking Union Hospital, CAMS & PUMC, Beijing 100730, China.
Zhao
Yan
Y
Wang
Shu-jie
SJ
Li
Tai-sheng
TS
Zhang
Jie-ping
JP
Zhao
Yong-qiang
YQ
Duan
Yun
Y
Zhang
Feng-chun
FC
Tang
Fu-lin
FL
Bai
Lian-jun
LJ
Cui
Wei
W
Wu
Pei
P
Zhang
Fu-quan
FQ
Shen
Ti
T
D000293:Adolescent; D000328:Adult; D018952:Antigens, CD34 / Q000032:analysis*; D001327:Autoimmune Diseases / Q000276:immunology / Q000628:therapy*; D005260:Female; D006410:Hematopoiesis; D019650:Hematopoietic Stem Cell Mobilization; D006801:Humans; D007108:Immune Tolerance; D008297:Male; D008875:Middle Aged; D036102:Peripheral Blood Stem Cell Transplantation / Q000009:adverse effects / Q000401:mortality; D014182:Transplantation, Autologous
D018952:Antigens, CD34