Hematopoietic stem cell transplantation for autoimmune disorders.

Autologous hemopoietic stem cell transplantation (HSCT) for autoimmune disease has increased lately. Insights into response to immunoablation is found in animal experiments and reports on patients receiving HSCT for concomitant malignancy. Early phase II studies and case reports of HSCT in patients with multiple sclerosis, systemic sclerosis, lupus erythematosus, rheumatoid arthritis, juvenile chronic arthritis and idiopathic thrombocytopenic purpura have been published. Dramatic responses or disease stabilization have been observed in some, but failures and disease relapses, toxic and infectious complications have been observed in others. Whether this treatment can induce true peripheral immunologic tolerance, and which been observed if any patients will benefit long-term from HSCT, remains to be determined.