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Blood, 1 April 2005, Vol. 105, No. 7, pp. 2991-2994.
Prepublished online as a Blood First Edition Paper on December 16, 2004; DOI 10.1182/blood-2004-09-3715.


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TRANSPLANTATION
Brief report

Control of systemic B cell-mediated autoimmune disease by nonmyeloablative conditioning and major histocompatibility complex-mismatched allogeneic bone marrow transplantation

Roelof Flierman, Hendrik J. Witteveen, Ellen I. H. van der Voort, Tom W. J. Huizinga, René R. P. de Vries, Willem E. Fibbe, René E. M. Toes, and Jacob M. van Laar

From the Departments of Rheumatology, Immunohematology and Blood Transfusion, and Hematology, Leiden University Medical Center, Leiden, The Netherlands.

Systemic autoimmune disease (AID) can be controlled with conventional therapies in most patients. However, relapses are common, leading to progressive disability and premature death. Nonmyeloablative conditioning and allogeneic bone marrow transplantation (BMT) could be an effective treatment for severe AID, because of mild toxicity of the conditioning and the potential benefits of donor chimerism. We examined the effects of this treatment in experimental autoimmune arthritis. Our results demonstrate the induction of complete donor chimerism and significant suppression of disease activity. No clinical graft-versus-host disease (GVHD) was observed. The beneficial effects were most likely caused by the elimination of plasma cells producing pathogenic autoantibodies, because these antibodies disappeared rapidly after BMT. Although this type of treatment was effective in organ-specific T-cell-mediated AID, the present study provides convincing evidence that nonmyeloablative conditioning and allogeneic BMT can effectively treat severe B-cell-mediated AID with a systemic inflammatory component.


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Related Article in Blood Online:

From animals to clinic: nonmyeloablative conditioning and allogeneic bone marrow transplantation in autoimmune disease
Richard K. Burt
Blood 2005 105: 2623-2624. [Full Text] [PDF]



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R. Flierman, G. Westerhuis, M. Hameetman, L. M. van Duivenvoorde, T. van Hall, J. M. van Laar, W. E. Fibbe, and R. E. M. Toes
Targeting host B-cell immune responses by persistent donor NK-cell alloreactivity following nonmyeloablative allogeneic stem cell transplantation
Blood, June 15, 2007; 109(12): 5524 - 5525.
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