[Late results of high-dose immunosuppressive therapy with autotransplantation of hematopoietic stem cells in patients with severe refractory systemic lupus erythematosus].

The aim of the study was to assess long-term results of high-dose immunosuppressive therapy with autoimplantation of hemopoietic stem cells in patients with severe systemic lupus erythematosus (SLE) resistant to standard immunosuppressive therapy and compare them with the outcome of the two modalities. The study and control groups comprised 15 women each aged 18-55 and 20-55 years respectively. The results were estimated 1 months after the onset of therapy and during the 45 +/- 10.4 (study) and 30 +/- 7.6 (control) month follow-up. Combined treatment resulted in complete remission (SLEDAI below 3) in 6 (40%) and reduced SLE activity in 6 (40%) patients. The effect was absent in 1 (7%) patient, 2 others died. Remission and reduced SLE activity occurred in 1 (7%) and 1 (7%) patients of the control group respectively, 13 (87%) failed to benefit from therapy, and 1 (7%) died. Seven (47%) patients given combined treatment suffered recurrence of SLE, 3 (20%) had complete or partial remission, and 3 died during the long-term follow-up. Five-year survival rate was 80%. None of the patients in the control group showed remission in the late posttreatment period, SLE activity remained unaltered in 8 and progressed in 4; two patients died. Five-year survival rate was 70%. It is concluded that high-dose immunosuppressive therapy with autoimplantation of hemopoietic stem cells is an efficacious tool for the treatment of lupus erythematosus resistant to standard therapy and has advantages over the latter.