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Stem Cell Transplants

 

Stem Cell Transplants are still in the experimental stage as a treatment for lupus.

Stem Cells are the undifferentiated, or immature blood cells, that turn into mature cells in the bone marrow. This treatment has been used in cancer treatments for 20 years, notably aplastic anemia, but the application in other autoimmune disorders such as Multiple Sclerosis, and Lupus, is relatively recent and heavily experimental.

The treatment works on the principle that once the immune system slate is wiped clean, the body can re-learn how to defend itself properly again.

In people with autoimmune disorders, the immune system attacks its own tissues and organs and must be re-taught to differentiate between the body's own cells and foreign attackers. "This therapy is analogous to rebooting a computer -- you wipe out the old information, then allow it to re-learn. The immune system that returns should function normally,". -Richard Jones, M.D., Director of Bone Marrow Transplantation, Johns Hopkins

First, a source of potentially health cells must be found. Two approaches are to use the patient's own cells (auto-logous), and to find a suitable donor (allo-genic). Many think the allogenic donation is preferable, because that way the patient can start with a completely clean slate. The stem cells are conditioned to purge most of the immune cells. To eliminate the wayward cells, either high-dose cytotoxic (cell-killing) medications are used, or total-body radiation. Then the donated cells are reinfused into the body, and the process of re-keying the immune system hopefully begins.

Even to be considered for this treatment, the patient must have failed to benefit from all other conventional therapies. It must be a matter of life and death. However, at the same time, the patient must be able to tolerate the treatment. For example, at South Texas Cancer Treatment Institute, here are the eligibility criteria for being accepted on autoimmune protocols:

Lupus:

  • Less than 60 years of age.
  • Established clinical diagnosis with one of the following malignant features:
  • nephritis
  • vasculitis/immune complex deposition
  • hematologic cytopenias
  • catastrophic anti-phospholipid syndrome

The medications used are extremely toxic, and complications leading to a lengthy hospitalization can result. As with any radical treatment, a small number of patients could even die from treatment-related complications. The treatments is very expensive, and most likely not covered by insurance. However, on an individual basis, some are getting coverage, or getting drug companies to donate medications.

The Kiel Research Group for Autoimmune diseases has an interesting explanation for why there is no way at present to define cure in terms of SLE. Up until this point, there hasn't been a need to define cure, because a cure has not been possible. However, with the increasing activity on the stem cell transplant front, they have petitioned the American College of Rheumatology (ACR) to define a cure for lupus in these terms:

Long-term and treatment-free complete clinical remision with restoration of normal blood counts and a normal immune system.

 
 

 


 
 
 

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