Harvard Women's Health Watch

In brief: Severe lupus responds to stem cell therapy

In brief

Severe lupus responds to stem cell therapy

Lupus — more accurately called systemic lupus erythematosus (SLE) — is a chronic autoimmune disease that affects some 1.5 million people, 90% of them women. It usually starts during the childbearing years. Lupus causes the immune system to turn on the body and attack various organs and tissues, especially the skin and joints. It can also cause inflammation in the kidneys, lungs, blood vessels, and brain. Lupus ranges in severity from mild disease characterized by skin rashes, achy joints, and fatigue to serious conditions resulting from damage to the kidneys, lung, heart, and brain. Symptoms tend to come and go as periods of illness (flares) alternate with remissions.

The goal of treatment, which may involve powerful anti-inflammatory drugs, steroids, and chemotherapy, is to prevent flares and treat symptoms when they occur. Most people with lupus can lead active lives. But for those who don't respond to the usual therapies, lupus can be debilitating, even life-threatening. That's why word of success with an aggressive treatment for difficult-to-control lupus is so exciting.

Researchers at Northwestern University's Feinberg School of Medicine reported in the Feb. 1, 2006, issue of the Journal of the American Medical Association (JAMA) that 50% of patients with severe lupus who underwent a procedure called autologous stem cell transplant were free of symptoms for five years or more. This stem cell transplant process is similar to the bone marrow transplants used in treating certain types of cancer. But in this case, physicians collect and treat the patients' own stem cells — immature cells capable of developing into many different cell types throughout the body — and return them to the body after a course of high-dose chemotherapy. The idea is that the misguided immune system cells will be eliminated by the chemotherapy and the stem cells will restore normal immune function. In the study, treatment required several weeks in the hospital, prophylactic antibiotics for six months, and antiviral drugs for one year after transplantation.

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