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 Prepublished online as a Blood First Edition Paper on October 10, 2002; DOI 10.1182/blood-2002-07-2122.

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Submitted July 15, 2002
Accepted September 30, 2002

High-dose immune suppression and autologous hematopoietic stem cell transplantation in refractory Crohn's Disease

Richard K Burt*, Ann E Traynor, Yu Oyama, and Robert Craig

Division of Immunotherapy, Northwestern University Medical Center, Chicago, IL, USA

* Corresponding author; email: rburt{at}nwu.edu.

Two patients with severe Crohn's disease, defined by a Crohn's Disease Activity Index (CDAI) greater than 250 despite anti-tumor necrosis factor alpha (TNF{alpha}) were treated by intense immune suppression and autologous hematopoietic stem cell transplantation (HSCT). Stem cells were mobilized from the peripheral blood using cyclophosphamide (2.0 g/m2) and G-CSF (5 ug/kg/day), enriched ex vivo by CD34+ selection, and reinfused after immune conditioning with cyclophosphamide (200 mg/kg) and equine anti-thymocyte globulin (ATG) (90 mg/kg). Patients have remained in remission (CDAI < 100) since HSCT, 12 and 15 months, respectively. We conclude that further HSCT studies for severe Crohn's disease appear warranted.


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