ABSTRACT

Systemic lupus erythematosus (SLE) is a systemic, clinically and genetically heterogenous disease characterized by diffuse tissue damage mediated in great part by autoimmune pathogenic reactions. Notwithstanding impressive therapeutic progress and significant amelioration of quantity and quality of life, there are still intractable cases which demand more incisive interventions. Hematopoietic stem cell transplantation (HSCT) was first proposed in 1993, 1 and the first two patients underwent autologous transplants (ASCT) in 1997. 2 , 3 Since then, the procedure has been performed worldwide, including the largest ongoing single center study at Northwestern University, Chicago 4-6 and a multicentric registry study by the European Group for Blood and Marrow Transplantation (EBMT) and the European League against Rheumatism (EULAR); 7 summarizing individual center experience in Europe. A National Institutes of Health (NIH) funded phase III clinical trial of HSCT for refractory SLE is anticipated to begin in 2003/2004. Encouraging results are raising new questions about the role of HSCT in SLE, as well as in other severe autoimmune diseases. 8