PROGRESS IN TREATMENT OF SEVERE SYSTEMIC LUPUS DISEASE (p701) [The Lancet]
Research published in this week's issue of THE LANCET suggests that the combination of high dose chemotherapy and stem-cell transplantation could be an innovative treatment for severe systemic lupus disease.
Systemic lupus erythematosus (SLE) is a serious, acquired disorder effecting young and middle aged people, most of them female. Several hundred thousand individuals in the USA, for example, have lupus; between 10% and 15% of these are projected to die within ten years of their diagnosis. The immune cells of lupus-affected individuals fail to
recognise their own tissues and attack organs in the manner that immune cells normally reject foreign organisms, tumors or grafts. This process can lead to destruction of the normal kidney, heart, brain, spine, and lung tissue. When uncontrolled, this process can lead to death. Current therapies include chronic glucocorticoids and immune-suppressive medications including chemotherapy, Patients with SLE who experience persistent multi-organ dysfunction, despite standard doses of intravenous cyclophosphamide, represent a subset at high risk of early death.
Ann Traynor and colleagues from Northwestern University, Chicago, USA, investigated the safety and efficacy of high dose immune suppression and stem-cell transplantation to treat high-risk patients. From 1996, they selected patients with persistent, aggressive SLE despite the use of cyclophosphamide. Patients underwent high-dose immune suppression and stem-cell infusion. Peripheral white blood cells were analysed before and after transplantation.
All patients were free from signs of active disease at an average follow-up of two years after treatment, and kidney, heart, lung, and immune system function had become normal.
Ann Traynor comments: "What is exciting about this observation is that it appears that the immune system can correct its errors if early stem cells are allowed to mature as naive cells in a "neutral" environment. This new generation of immune cells is not destined to repeat the ruinous errors of the prior generations. This observation may have implication for the therapy of many immune disorders including multiple sclerosis, myasthenia gravis, and even some types of cancers". (Quote by e-mail; does not appear in published paper).
Contact: Elizabeth Crown, Health Sciences Editor, University Relations, Northwestern University School of Medicine, Chicago, IL 60611 USA; T) +1 312 503 8928; F)+1 312 503 6743; E) e-crown@nwu.edu. |
