HSCs are being used to treat patients with nonmalignant, nonhematologic diseases. A list of some of these diseases is included in the table.
HSC Therapy for Nonmalignant Diseases
Disease | Benefit |
Multiple sclerosis | Significant improvement in neurologic function |
Systemic sclerosis | Improved joint flexibility, reversal of skin tightness, improved quality of life |
Lupus erythematosus | Remission and survival after 5 years |
Crohn's disease | Remission in some cases |
Myocardial infarction | Improved recovery of left ventricular contractility |
Peripheral vascular disease | Pain relief, limb salvage, functional improvement |
Type 1 diabetes mellitus | Increased insulin production, decreased glycosylated hemoglobin |
Rheumatoid arthritis | Reduction in the rate of joint damage |
Vasculitis | Complete remission in some cases |
HSC infusion treatment for patients with severe autoimmune diseases began in the late 1990’s. Most of the transplants have been autologous with minimal myeloablative or nonmyeloablative conditioning. Allogeneic transplants although potentially a cure, are rarely performed due to increased complications such as GVHD and myelodysplasia. Since these are often chronic diseases, treatment mortality needs to be low. In one study, treatment mortality was less than 1% in patients who received nonmyeloablative therapy, 2% for patients treated with low-intensity myeloablative therapy, and 13% with high-intensity myeloablative therapy. The current nonmyeloablative conditioning therapy uses rituximab, cyclophosphamide, and recombinant antithymocyte globulin (rATG).