On reversing the persistence of memory: Hematopoietic stem cell transplant for autoimmune disease in the first ten years

Successful treatment of a case of catastrophic antiphospholipid syndrome with autologous BMT: case report and review of literature

“…[4][5][6] The concept of using SCT for treatment of refractory autoimmune disorders was introduced to medical practice after early encouraging data in animal models. [7][8][9] In autoimmune conditions, disease arises from failure to inhibit polyclonal expansion and activation upon exposure to self-Ags that results from a failure of normal mechanisms to suppress proliferation in the presence of innocuous or self-Ags. 8,9 The rational behind using SCT is based on ablation of clonal memory cells by cytotoxic drugs followed by introduction of stem cells for immune reconstitution, or an 'immune reset'.…”

“…[7][8][9] In autoimmune conditions, disease arises from failure to inhibit polyclonal expansion and activation upon exposure to self-Ags that results from a failure of normal mechanisms to suppress proliferation in the presence of innocuous or self-Ags. 8,9 The rational behind using SCT is based on ablation of clonal memory cells by cytotoxic drugs followed by introduction of stem cells for immune reconstitution, or an 'immune reset'. 9,10 Because the first report of successful autologous SCT procedure for systemic lupus erythematosus (SLE) by Marmont et al, 11 many larger studies have shown the beneficial effect of both autologous and allogeneic SCT in SLE and other autoimmune disorders such as rheumatoid arthritis (RA) systemic sclerosis, inflammatory bowel disease and autoimmune thyroiditis.…”

“…8,9 The rational behind using SCT is based on ablation of clonal memory cells by cytotoxic drugs followed by introduction of stem cells for immune reconstitution, or an 'immune reset'. 9,10 Because the first report of successful autologous SCT procedure for systemic lupus erythematosus (SLE) by Marmont et al, 11 many larger studies have shown the beneficial effect of both autologous and allogeneic SCT in SLE and other autoimmune disorders such as rheumatoid arthritis (RA) systemic sclerosis, inflammatory bowel disease and autoimmune thyroiditis. [12][13][14][15][16] Although most of these reports had few patients, the response rate was encouraging.…”

“…However, while most centers reported an initial response to SCT in patients with autoimmune disorders, recurrence of disease is a common theme. 9,12 The successful results of SCT for some autoimmune disorders have encouraged physicians to extend the use for other autoimmune disorders including APS. Early animal models showed the effectiveness of SCT in APS.…”

Malignancies and Catastrophic Anti-phospholipid Syndrome

“…There are also discussions of the use of autoantibodies to treat malignancies. We will not discuss this literature but note several recent citations [49][50][51][52][53][54][55].…”