AUTOLOGOUS MARROW STEM-CELL TRANSPLANTATION FOR SEVERE SYSTEMIC LUPUS-ERYTHEMATOSUS OF LONG-DURATION

A 46 year woman with severe long-lasting SLE received an autologous bo ne marrow transplantation utilising CD34(+) haematopoietic progenitors following a 3 log T-lymphocyte depletion. The immunosuppressive regim en (conditioning) consisted of 15 mg/kg Thiotepa followed by 100 mg/kg of cyclophosphamide over 2 d. Granulocytic recovery was aided by G-CS F. The post-transplant course was uneventful, and a good clinical and immunologic remission (ANA negativisation) was achieved. This is the f irst case of SLE having received an autologous progenitor cell transpl ant for the autoimmune disease by itself, unaccompanied by a haematolo gic condition requiring transplantation. The potential, advantages and limits of this procedure, which are currently being explored worldwid e, are briefly discussed.