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High-dose immune suppression and autologous hematopoietic stem cell transplantation in refractory Crohn disease.
- Source :
-
Blood [Blood] 2003 Mar 01; Vol. 101 (5), pp. 2064-6. Date of Electronic Publication: 2002 Oct 10. - Publication Year :
- 2003
-
Abstract
- Two patients with severe Crohn disease, defined by a Crohn Disease Activity Index (CDAI) higher 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 granulocyte colony-stimulating factor (G-CSF; 5 micro g/kg/d), 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) for 1 year since HSCT. We conclude that further HSCT studies for severe Crohn disease appear warranted.
- Subjects :
- Adolescent
Adult
Anti-Infective Agents therapeutic use
Antilymphocyte Serum
Autoimmune Diseases drug therapy
Autoimmune Diseases immunology
Combined Modality Therapy
Crohn Disease drug therapy
Crohn Disease immunology
Cyclophosphamide pharmacology
Female
Granulocyte Colony-Stimulating Factor pharmacology
Hematopoietic Stem Cell Mobilization
Humans
Immune Tolerance
Immunosuppressive Agents administration & dosage
Infection Control
Male
Neutropenia etiology
Remission Induction
Salvage Therapy
Severity of Illness Index
T-Lymphocytes
Transplantation Conditioning
Transplantation, Autologous immunology
Autoimmune Diseases therapy
Crohn Disease therapy
Immunosuppressive Agents therapeutic use
Peripheral Blood Stem Cell Transplantation
Subjects
Details
- Language :
- English
- ISSN :
- 0006-4971
- Volume :
- 101
- Issue :
- 5
- Database :
- MEDLINE
- Journal :
- Blood
- Publication Type :
- Academic Journal
- Accession number :
- 12393477
- Full Text :
- https://doi.org/10.1182/blood-2002-07-2122