Abstract
This ongoing multicentre prospective phase I/II trial enrolled 74 consecutive patients from 22 centres worldwide with severe autoimmune disease, 35 with rheumatological disorders, 31 with neurological, five with haematological and three with vasculitides. They were treated with autologous peripheral blood or bone marrow transplants according to predetermined criteria. Two patients died after mobilisation before transplant. Seventy-two patients were given 73 transplants, seven bone marrow, and 66 mobilised peripheral blood stem cell transplants. The graft was manipulated to remove T and/or B cells in 43 cases. All 73 transplants engrafted. Five patients died of transplant-related complications: two from bleeding, three from infections. Two patients died of progressive disease. The transplant-related mortality at 1 year of 9% (1–17%; 95% CI) is comparable to the transplant-related mortality of 6% (3–9%; 95% CI) in patients transplanted during the same period in Europe for non-Hodgkin’s lymphoma in sensitive relapse (P = 0.39). Sixty patients are evaluable for response, 40 patients (65%) showed some improvement in their disease. Haematopoietic stem cell transplants are feasible for patients with severe refractory autoimmune disease. Transplant-related mortality is comparable to results in patients with non-Hodgkin’s lymphoma in responsive relapse. Two-thirds of the patients show at least some response. These preliminary data are promising. Although associated with considerable risk, randomised trials comparing autologous stem cell transplants to conventional therapy are warranted.
This is a preview of subscription content, access via your institution
Access options
Subscribe to this journal
Receive 12 print issues and online access
$259.00 per year
only $21.58 per issue
Rent or buy this article
Prices vary by article type
from$1.95
to$39.95
Prices may be subject to local taxes which are calculated during checkout
Similar content being viewed by others
Author information
Authors and Affiliations
Consortia
Rights and permissions
About this article
Cite this article
Tyndall, A., Fassas, A., Passweg, J. et al. Autologous haematopoietic stem cell transplants for autoimmune disease – feasibility and transplant-related mortality. Bone Marrow Transplant 24, 729–734 (1999). https://doi.org/10.1038/sj.bmt.1701987
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1038/sj.bmt.1701987
Keywords
This article is cited by
-
80 Meilensteine der Rheumatologie aus 80 Jahren – III: 1980–2000
Zeitschrift für Rheumatologie (2021)
-
Gangrenous toes
Hellenic Journal of Surgery (2016)
-
Prolonged transendothelial migration of human haematopoietic stem and progenitor cells (HSPCs) towards hydrogel-released SDF1
Annals of Hematology (2011)
-
Impaired bone marrow hematopoietic progenitor cell function in rheumatoid arthritis patients candidated to autologous hematopoietic stem cell transplantation
Bone Marrow Transplantation (2004)
-
Donor lymphocyte infusions for refractory pure red cell aplasia relapsing after both autologous and nonmyeloablative allogeneic peripheral stem cell transplantation
Bone Marrow Transplantation (2004)