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    Autoimmun Rev. 2006 Mar;5(3):167-79. Epub 2005 Jul 26.

    Hematopoietic stem cell transplantation (HSCT): an approach to autoimmunity.

    Alaez C, Loyola M, Murguía A, Flores H, Rodríguez A, Ovilla R, Ignacio G, Amador R, Salinas V, Perez F, Rodríguez D, Morales Z, Llinguin G, Vazquez A, Altamirano A, Gorodezky C.

    Department of Immunology and Immunogenetics, Instituto de Diagnóstico y Referencia Epidemiológicos-InDRE, Secretary of Health (SSA), Mexico City, Mexico.

    HSCT provides the opportunity to replace a damaged tissue. It is the most important treatment for high risk hematologic malignant and non malignant disorders. An important challenge in the identification of matched donors/patients is the HLA diversity. The Mexican Bone Marrow Registry (DONORMO) has nowadays > 5000 donors. The prevalent alleles are Amerindian, Mediterranean (Semitic and Spanish genes) and African. In theory, it is possible to find 11% of 6/6 A-B-DR low resolution matches for 70% of patients with Mexican ancestry. We contributed with 39 unrelated, cord blood and autologous HSCT for patients with malignant, genetic and autoimmune disorders. Overall disease survival was 50% (2-7 years) depending on the initial diagnosis, conditioning, disease evolution or other factors. Clinical studies using autologous and unrelated HSC are performed on patients with refractory autoimmune diseases producing mixed results: mainly, T1D, RA, MS, SLE. Improvement has been observed in skin damage and quality of life in SLE and systemic sclerosis. Disease stabilization in 2/3 of MS patients. However, in RA and T1D, initial benefits have been followed by eventual relapse. With growing clinical experience and protocol improvement, treatment-related mortality is decreasing. Proof efficacy will be achieved by comparing HSCT with standard therapy in autoimmunity.

    PMID: 16483916 [PubMed - indexed for MEDLINE]

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