Intensive immunosuppression with high dose cyclophosphamide but without stem cell rescue for severe autoimmunity: Advantages and disadvantages

Research output: Contribution to journalArticle

Abstract

Hematopoietic stem cell transplantation (HSCT) for the treatment of severe autoimmune disorders continues to show great promise. The morbidity and mortality of the approach is relatively low and clinical benefit has been demonstrated in many, but not all patients. Furthermore, relapse following HSCT is not uncommon. Most centers now prefer onmyeloablative conditioning regimens using high dose cyclophosphamide prior to SCT; however, emerging data show that high dose cylophosphamide can be adminstered safely without the need for HSCT. Eliminating the use of HSCT after high dose cyclophosphamide shortens the duration of the procedure by several weeks, markedly reduces the cost of the procedure and eliminates the potential of reinfusing autoreactive lymphoctes with the autograft.

Original languageEnglish (US)
Pages (from-to)596-600
Number of pages5
JournalAutoimmunity
Volume41
Issue number8
DOIs
StatePublished - 2008

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Hematopoietic Stem Cell Transplantation
Autoimmunity
Cyclophosphamide
Immunosuppression
Stem Cells
Autografts
Morbidity
Costs and Cost Analysis
Recurrence
Mortality
Therapeutics

Keywords

  • Aldehyde dehydrogenase
  • Autoimmunity
  • High-dose cyclophosphamide

ASJC Scopus subject areas

  • Immunology and Allergy
  • Immunology

Cite this

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abstract = "Hematopoietic stem cell transplantation (HSCT) for the treatment of severe autoimmune disorders continues to show great promise. The morbidity and mortality of the approach is relatively low and clinical benefit has been demonstrated in many, but not all patients. Furthermore, relapse following HSCT is not uncommon. Most centers now prefer onmyeloablative conditioning regimens using high dose cyclophosphamide prior to SCT; however, emerging data show that high dose cylophosphamide can be adminstered safely without the need for HSCT. Eliminating the use of HSCT after high dose cyclophosphamide shortens the duration of the procedure by several weeks, markedly reduces the cost of the procedure and eliminates the potential of reinfusing autoreactive lymphoctes with the autograft.",
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AB - Hematopoietic stem cell transplantation (HSCT) for the treatment of severe autoimmune disorders continues to show great promise. The morbidity and mortality of the approach is relatively low and clinical benefit has been demonstrated in many, but not all patients. Furthermore, relapse following HSCT is not uncommon. Most centers now prefer onmyeloablative conditioning regimens using high dose cyclophosphamide prior to SCT; however, emerging data show that high dose cylophosphamide can be adminstered safely without the need for HSCT. Eliminating the use of HSCT after high dose cyclophosphamide shortens the duration of the procedure by several weeks, markedly reduces the cost of the procedure and eliminates the potential of reinfusing autoreactive lymphoctes with the autograft.

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