Future strategies in hematopoietic stem cell transplantation for rheumatoid arthritis

Patients with coincidental rheumatoid arthritis (RA) treated by allogeneic hematopoietic stem cell transplantation (HSCT) for drug induced aplastic an emia have been fortuitously cured of RA. Other than these examples with all ogeneic HSCT, there is no known curative therapy for RA. Despite its potent ial to cure, allogeneic transplantation is not being offered to patients wi th RA due to transplant related mortality. Advances in HSCT conditioning re gimens and better prevention or graft-versus-host disease should allow cons ideration of allogeneic HSCT as therapy for severe RA. We propose a new, we ll tolerated, nonmyeloablative allogeneic stem cell transplant regimen as t reatment for RA.