EARLY RECURRENCE OR PERSISTENCE OF AUTOIMMUNE-DISEASES AFTER UNMANIPULATED AUTOLOGOUS STEM-CELL TRANSPLANTATION

Autologous stem cell transplantation with or without in vitro lymphocy te depletion has been suggested as a new treatment option for severe a utoimmune diseases. We describe five patients with autoimmune diseases (CREST syndrome, myasthenia gravis and Hashimoto's thyroiditis, syste mic lupus erythematosus, atopic dermatitis, and rheumatoid arthritis) who underwent autologous bone marrow (n = 1) or peripheral blood proge nitor cell (n = 4) transplantation with unmanipulated grafts as treatm ent for the autoimmune disease in one case or as treatment for a malig nant disorder with a concomitant autoimmune disorder in four cases. In all patients serological and clinical signs of the autoimmune disease recurred early or persisted, These observations should be regarded as a cautionary note concerning the efficacy of high-dose therapy follow ed by transplantation of unmanipulated autologous stem cells for treat ment of severe autoimmune diseases. (C) 1996 by The American Society o f Hematology.