What is the role of stem cell transplantation in SLE?
Hematopoietic stem cell transplantation (HSCT) has been utilized in the past 15 years for SLE to eliminate autoreactive lymphocytes and replace them with undifferentiated cells. Autologous bone marrow transplant using various conditioning regimens has been completed in a small number of patients. In one recent study, 62% of SLE patients on a particular protocol were considered to be in remission (on only hydroxychloroquine and/or less than 10 mg of prednisone) 5 years after HSCT. Other studies report a high incidence of treatment-related complications such as infection. HSCT should be reserved for patients with refractory life-threatening disease.