Autologus blood stem cell transplantation as therapy for autoimmune disease

Autologous stem cell transplantation (ASCT) is starting to be investigated as a potential therapy for severe refractory autoimmune disease including r heumatological, neurological and haematological diagnoses. Increasing numbe rs of cases are now reported in the literature. Data from all transplanted patients are being collated in a centralized register by the European Group for Blood and Marrow Transplantation (EBMT) and the European League agains t Rheumatism (EULAR) to enable effective evaluation of the safety and effic acy of this promising technique. Thus far, results have been encouraging; h owever, more treatment-related deaths were reported in multiorgan diseases such as scleroderma and less in diseases such as rheumatoid arthritis, whic h confirms the importance of careful patient selection. Optimization of mob ilization, conditioning regimen and graft manipulation is required to maxim ize efficacy without increasing mortality and morbidity. The use of mainten ance therapy after ASCT in order to prevent relapse needs to be explored. F ollowing individual case reports and small cohort studies, the next step is likely to involve multicentre randomized controlled trials.