Review article: Stem cell transplantation for the treatment of gastrointestinal diseases--current applications and future perspectives.
BACKGROUND
Haematopoietic stem cell transplantation (HSCT) can be used to cure or ameliorate a variety of non-malignant diseases. These range from inherent defects of haematopoiesis, through metabolic diseases, to severe autoimmune diseases. The rationale for this strategy is based on the concept of immunoablation using high-dose chemotherapy, with subsequent regeneration of naïve T-lymphocytes derived from reinfused haematopoietic progenitor cells. Possibly the use of SCT allows the administration of high-dose chemotherapy resulting in a prompt remission in these therapy-refractory patients.


OBJECTIVE
This review highlights the major scientific developments and defines the areas of successful use of HSCT in gastrointestinal disorders and gives a perspective on possible future applications.


METHODS
A search in the Medline has been conducted and all relevant published data were analysed.


RESULTS
HSCT has been proved successful in treating refractory Crohn's disease. A selected group of refractory coeliac patients having a high risk of developing enteropathy associated T-cell lymphoma has been recently treated with promising results. In cryptogenic cirrhosis, basic research and unpublished data concerning mesenchymal SCT are encouraging.


CONCLUSIONS
In refractory autoimmune gastrointestinal diseases, it seems that high-dose chemotherapy followed by HSCT is feasible and safe and might result in long-term improvement of disease activity.
Al-Toma
A
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Department of Gastroenterology and Hepatology, VU University Medical Centre, Amsterdam, The Netherlands.
Mulder
C J J
CJ
D017024:Chemotherapy, Adjuvant / Q000379:methods; D005544:Forecasting; D005767:Gastrointestinal Diseases / Q000628:therapy*; D018380:Hematopoietic Stem Cell Transplantation / Q000379:methods / Q000639:trends*; D006801:Humans