title: Hematopoietic stem cell transplantation for non-malignant gastrointestinal diseases.
abstract: Both, autologous and allogeneic hematopoietic stem cell transplantation (HSCT) can be used to cure or ameliorate a variety of malignant and non-malignant diseases. The rationale behind this strategy is based on the concept of immunoablation using high-dose chemotherapy, with subsequent regeneration of naive T-lymphocytes derived from reinfused hematopoietic progenitor cells. In addition, the use of HSCT allows for the administration of high-dose chemotherapy (whether or not combined with immunomodulating agents such as antithymocyte globulin) resulting in a prompt remission in therapy-refractory patients. This review gives an update of the major areas of successful uses of HSCT in non-malignant gastrointestinal disorders. A Medline search has been conducted and all relevant published data were analyzed. HSCT has been proved successful in treating refractory Crohn's disease (CD). Patients with refractory celiac disease type II and a high risk of developing enteropathy associated T-cell lymphoma have shown promising improvement. Data concerning HSCT and mesenchymal SCT in end-stage chronic liver diseases are encouraging. In refractory autoimmune gastrointestinal diseases high-dose chemotherapy followed by HSCT seems feasible and safe and might result in long-term improvement of disease activity. Mesenchymal SCT for a selected group of CD is promising and may represent a significant therapeutic alternative in treating fistulas in CD.
authors.affiliation: Abdulbaqi Al-toma, Department of Internal Medicine and Gastroenterology, 3430 EM Nieuwegein, The Netherlands.
authors.forename: Abdulbaqi
authors.initials: A
authors.lastname: Al-toma
authors.affiliation: Abdulbaqi Al-toma, Department of Internal Medicine and Gastroenterology, 3430 EM Nieuwegein, The Netherlands.
authors.forename: Petula
authors.initials: P
authors.lastname: Nijeboer
authors.affiliation: Abdulbaqi Al-toma, Department of Internal Medicine and Gastroenterology, 3430 EM Nieuwegein, The Netherlands.
authors.forename: Gerd
authors.initials: G
authors.lastname: Bouma
authors.affiliation: Abdulbaqi Al-toma, Department of Internal Medicine and Gastroenterology, 3430 EM Nieuwegein, The Netherlands.
authors.forename: Otto
authors.initials: O
authors.lastname: Visser
authors.affiliation: Abdulbaqi Al-toma, Department of Internal Medicine and Gastroenterology, 3430 EM Nieuwegein, The Netherlands.
authors.forename: Chris J J
authors.initials: CJ
authors.lastname: Mulder
mesh_terms: D000818:Animals; D002446:Celiac Disease / Q000175:diagnosis / Q000276:immunology / Q000601:surgery*; D002908:Chronic Disease; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000175:diagnosis / Q000276:immunology / Q000601:surgery*; D008107:Liver Diseases / Q000175:diagnosis / Q000276:immunology / Q000601:surgery*; D012307:Risk Factors; D016896:Treatment Outcome
keywords: Celiac disease; Cirrhosis; Crohn’s; Hematopoietic stem cell transplantation; Lymphoma; Mesenchymal stem cells; Non-malignant gastrointestinal diseases; Refractory celiac disease; Ulcerative colitis