Development of a protocol for allogeneic marrow transplantation for severe systemic sclerosis: paradigm for autoimmune disease.
J Rheumatol Suppl
; 48: 72-8, 1997 May.
Article
em En
| MEDLINE
| ID: mdl-9150123
ABSTRACT
Some types of severe autoimmune disease are associated with significant morbidity and a high mortality rate. Many of these cases occur in young adults who, even if they survive, become severely debilitated. Systemic sclerosis (SSc) is a paradigm for other severe autoimmune diseases in which patients with poor prognostic features can be identified early in the course of the disease. Allogeneic marrow transplantation may be effective for the control of autoimmune diseases like SSc because the preparative regimen will significantly suppress the host immune system and the antihost effects of the donor immune system in the engrafted marrow will help maintain the suppression of the host immune system. Considering the morbidity and poor prognosis associated with severe SSc and the favorable outcome now associated with allogeneic marrow transplantation from HLA identical siblings for other nonmalignant diseases, Phase I and II studies are warranted. These will evaluate the safety of allogeneic marrow transplantation and explore its role in the management and control of a severe autoimmune disease. We review issues important in the development of an allogeneic marrow transplant protocol for severe SSc, including patient selection, plan of treatment, prevention of graft versus host disease, supportive care, and evaluation after transplant.
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Base de dados:
MEDLINE
Assunto principal:
Escleroderma Sistêmico
/
Doenças Autoimunes
/
Transplante de Medula Óssea
/
Condicionamento Pré-Transplante
/
Doença Enxerto-Hospedeiro
Tipo de estudo:
Guideline
/
Prognostic_studies
Idioma:
En
Revista:
J Rheumatol Suppl
Ano de publicação:
1997
Tipo de documento:
Article
País de afiliação:
Estados Unidos