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Rheumatology 1999; 38: 755-756
© 1999 British Society for Rheumatology

Paediatric Rheumatology: Autologous Stem Cell Transplantation in Rheumatic Diseases of Childhood

The role of T-cell depletion of autografts for autoimmune diseases

Series Editor: P. Woo

M. Bierings

University Hospital `Het Wilhelmina Kinderziekenhuis', Department of Haematology–Bone Marrow Transplantation, PO Box 18009, 3501 CA Utrecht, The Netherlands

Chemo-radiotherapy can lead to severe damage of the bone marrow and may lead to myelo-ablation. In order to overcome this toxicity, autologous haematopoietic stem cells can be infused. These stem cells can be either bone marrow derived or harvested from peripheral blood using leucapheresis. An unmanipulated bone marrow or peripheral blood autologous graft will contain considerable amounts of autologous T cells. With the infusion of the autologous stem cells, these T cells will be reintroduced into the patient.

Why consider T-cell depletion?

T cells might include autoreactive cells, responsible for autoimmune symptoms. Hence, re-infusion of autologous T cells may prevent the elimination of autoreactive T-cell clones. In 1996, Euler et al. [1] reported the early recurrence or persistence of autoimmune diseases after unmanipulated autologous stem cell . . . [Full Text of this Article]

Clinical experience so far

To what level should T cells be depleted?

T-cell depletion, at what cost?

Concluding remarks

References


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