Autologous blood stem cell transplantation in refractory systemic lupus erythematodes with recurrent longitudinal myelitis and cerebral infarction
| Autor: | Fritz G. Lehnhardt, U. Holtik, Lothar Burghaus, Michael Hallek, Andreas H. Jacobs, A. Ruger, P. Impekoven, C. Scheid, Michael Neveling, A. Rubbert |
|---|---|
| Rok vydání: | 2006 |
| Předmět: |
Adult
medicine.medical_specialty Cyclophosphamide medicine.medical_treatment Myelitis Hematopoietic stem cell transplantation 030204 cardiovascular system & hematology Gastroenterology Transplantation Autologous 03 medical and health sciences 0302 clinical medicine Rheumatology Antiphospholipid syndrome Recurrence Internal medicine medicine Humans Lupus vasculitis 030203 arthritis & rheumatology business.industry Lupus Vasculitis Central Nervous System Hematopoietic Stem Cell Transplantation Brain Cerebral Infarction medicine.disease Transplantation Methylprednisolone Spinal Cord Immunology Female Stem cell business medicine.drug |
| Zdroj: | Lupus. 15(4) |
| ISSN: | 0961-2033 |
| Popis: | Autologous hematopoietic stem cell transplantation (ASCT) has the potential to eliminate autoreactive lymphocytes and may represent a therapeutic option for patients with refractory autoimmune diseases. We describe a 19-year old woman with neuropsychiatric systemic lupus erythematodes (NPSLE) presenting with acute longitudinal myelitis and aseptic meningitis. Despite therapy with methylprednisolone and cyclophosphamide (CYC), recurrence of longitudinal myelitis and a disabling stroke-like relapse occurred. Hematopoietic stem cells were mobilized by CYC at 2 g/m2 and G-CSF. The patient was conditioned by CYC at 200 mg/kg and anti-thymocyte globulin and 3.6 = 106 CD34+ cells/kg were infused. Hematopoietic regeneration was observed on day 12 after ASCT. Currently, 18 months after ASCT, the patient is in clinical remission with no evidence for residual serological or neuroradiological activity of SLE. Although a longer follow-up will be needed to reliably assess the efficacy of ASCT in this patient, the present case demonstrates that ASCT may represent a therapeutic option for patients with severe NPSLE. |
| Databáze: | OpenAIRE |
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