PROLONGED REMISSION OF LONGSTANDING SYSTEMIC LUPUS-ERYTHEMATOSUS AFTER AUTOLOGOUS BONE-MARROW TRANSPLANT FOR NON-HODGKINS-LYMPHOMA

We describe a patient with longstanding steroid-dependent systemic lup us erythematosus (SLE) in whom clinical and serological remission was achieved following high-dose therapy and autologous bone marrow rescue for high-grade non-Hodgkin's lymphoma, However, 3 sears later, autoim mune disease re-presented in the form of immune thrombocytopenia (ITP) , which had not previously been a feature of the SLE, necessitating re introduction of steroid immunosuppression, Relapse of SLE is most like ly, although de novo ITP post-BMT is also a possibility, The case sugg ests that severe longstanding autoimmune disease may be controlled by high-dose therapy and autologous stem cell reconstitution, However, fu rther studies are required to determine the mechanism of re-emergence of autoimmunity and to evaluate optimal regimens and the potential val ue of such therapy in severe autoimmune diseases.