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Does hemopoietic stem cell transplantation have a role in treatment of severe rheumatoid arthritis?

journal contribution
posted on 2023-05-16, 12:04 authored by Raymond Lowenthal, Graham, S
Based on animal models and limited clinical experience, there is considerable interest in use of high-dose immunosuppression followed by hemopoietic stem cell transplantation as treatment for severe rheumatoid arthritis. Because of its relatively low treatment-related mortality and morbidity, autologous transplantation is a more attractive option than allogeneic transplantation for initial clinical trials, even though anecdotal reports suggest that allogeneic transplantation has a greater likelihood of bringing about long-term disease control. The approach remains experimental with many unanswered questions such as the value and safety of high-dose therapy without transplantation, the need for T cell purging, the possible deleterious effects of post-transplant hemopoietic growth factors and the potential of 'mini' allogeneic transplantation (a process whereby intense immunosuppression is combined with less intense myelosuppression). To achieve quick progress it is essential that clinical trials be carefully designed with all cases being reported to the Autoimmune Disease Stem Cell Project Database.

History

Publication title

Journal of Clinical Immunology

Volume

20

Pagination

17-23

ISSN

0271-9142

Department/School

Tasmanian School of Medicine

Publisher

Plenum Publishing Corp

Place of publication

Australia

Repository Status

  • Restricted

Socio-economic Objectives

Clinical health not elsewhere classified

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