Haematopoietic stem cell transplantation for autoimmune disease: Limits and future potential

Research output: Contribution to journalArticle

17 Scopus citations

Abstract

Stem cell transplantation (SCT) for autoimmune disease is handicapped by a lack of definitive clinical trials able to demonstrate an overall benefit. This deficiency will become more problematic as the impetus grows to introduce and evaluate additional technologies intended to improve the safety and efficacy of the procedure. The development of effective surrogate analyses to predict outcome by measuring resurgent autoimmune clones or by genomic- and proteomic-based technologies to detect early disease recurrence may be of value in assessing the benefits of these modifications without the need for full-scale, long-term, randomized trials. The introduction of safer allogeneic transplantation techniques may increase the effectiveness of the procedure, while work on marrow stem cell plasticity and/or fusion suggests that SCT may serve not simply to halt the autoimmune process, but also to contribute cells capable of healing or regenerating diseased organs. Finally, the introduction of therapeutic transgenes into transplanted cells may further increase the effectiveness of SCT, although the regulatory complexities of gene therapy trials will probably delay this process. All these innovations will ensure that the next decade will see major changes in the practice and purpose of SCT for autoimmune disease.

Original languageEnglish (US)
Pages (from-to)359-374
Number of pages16
JournalBest Practice and Research: Clinical Haematology
Volume17
Issue number2
DOIs
StatePublished - Jun 2004

Keywords

  • Allogeneic stem cell transplantation
  • Autoimmune disease
  • Autologous stem cell transplantation
  • Gene transfer
  • Regulatory T-cells
  • Stem cell plasticity
  • Surrogate markers

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

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