title: Stem cell transplantation as rescue therapy for refractory Crohn's disease: a sytematic review.
abstract: BACKGROUND
  Crohn's disease is a chronic relapsing- remitting affection. It has a strong immunologic component which represent the target of standard therapies including immunosppressants and biological therapies. However, many patients remain refracory or intolerant to these therapies.
  
  
  OBJECTIVE
  The aim of this review is to determine the effects of stem cell transplantation in patients with refractory Crohn's disease.
  
  
  METHODS
  Systematic review of observational studies, clinical trials and case reports that focused on the effectiveness and safety of stem cell transplantation in patients with refractory Crohn's disease.
  
  
  RESULTS
  Hematopoietic stem cell transplantation seems to be efficient in maintaining clinical and endoscopic remission in patients with Crohn's disease refractory or intolerant to current therapies. However, it has been associated to high morbidity and mortality due to chemotherapy. Mesenchymal stem cell transplantation could induce remission in patients with fistulising refractory Crohns disease with no severe side effects. Its impact on luminal Crohns disease is still controversial.
  
  
  CONCLUSIONS
  Stem cell transplantation seems to hold promising in patients with refractory Crohn's disease. However, because of the high morbidity and mortality related to chemotherapy, hematopoietic stem cell transplantation should be used as last resort to control this disease. Effectiveness of mesenchymal stem cell transplantation in luminal Crohn's disease has yet to be proven.
authors: Asma
authors: A
authors: Labidi
authors: Meriem
authors: M
authors: Serghini
authors: Nadia
authors: N
authors: Ben Mustapha
authors: Monia
authors: M
authors: Fekih
authors: Jalel
authors: J
authors: Boubaker
authors: Azza
authors: A
authors: Filali
mesh_terms: D001688:Biological Products / Q000008:administration & dosage; D003424:Crohn Disease / Q000188:drug therapy / Q000601:surgery*; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage; D033581:Stem Cell Transplantation; D017211:Treatment Failure
chemical_list: D001688:Biological Products; D007166:Immunosuppressive Agents