NEW CELL AND CYTOKINE TARGETS II
Stem cell transplantation: a treatment option for severe systemic sclerosis?
1 Musculoskeletal Research Group, Institute of Cellular Medicine, Newcastle University, Newcastle, UK
2 Service Medicine Interne, Hopital St Louis, Paris, France
3 Department of Rheumatology, University Hospital Basel, Basel, Switzerland
Correspondence to:
Professor J M van Laar, Musculoskeletal Research Group, Institute of Cellular Medicine, The Medical School, Cookson Building, Framlington Place, Newcastle NE2 4HH, UK; j.m.van-laar{at}ncl.ac.uk
High-dose immunosuppressive therapy and autologous stem cell transplantation (commonly referred to as "stem cell transplantation") is an established treatment for a variety of haemato-oncological conditions. Recent studies have confirmed its potent clinical and immunological effects in rheumatic autoimmune diseases, including severe diffuse systemic sclerosis (SSc). With modifications of treatment protocols and more stringent selection of patients, the safety profile of stem cell transplantation has improved as expressed in lower treatment-related morbidity and mortality. Prospective, randomised trials are in progress in Europe and North America to compare the safety and efficacy of stem cell transplantation with conventional chemotherapy in patients with early diffuse SSc, on the premise that induction of remission in early disease can be achieved by stem cell transplantation as a means to interrupt fibrogenesis.
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