Stem Cell Transplantation for the Treatment of Refractory Lupus Nephritis

Severe collagen vascular diseases can be partially controlled be conventional immunosuppressive drugs, particularly corticosteroids and cytotoxic agents, including methotreate and cyclophosphamide. In a minority of patients these diseases, the disease progression is relentless in despite aggressive use of chemotherapy. Within the last few years there has been considerable interest in using high dose therapy with autologous stem cell transplantation to treat severe autoimmune diseases. For the last three years we have had an active protocol for autologous stem cell transplantation to treat severe Systemic Lupus Erythematosis (SLE). During this period 19 patients were evaluated for stem cell transplantation. One patient, a woman with severe SLE with renal involvement was eligible and received autologous stem cell transplantation. She is without evidence of active disease in excess of three years from her transplant. A second eligible patient died of complications of treatment three weeks after transplant. The remaining patients did not meet protocol criteria.