Clinical Rheumatology

, Volume 24, Issue 5, pp 464–468

Use of CD34+ autologous stem cell transplantation in the treatment of children with refractory systemic lupus erythematosus

  • J. Chen
  • Y. Wang
  • G. Kunkel
  • H. Zhao
  • H. Xue
  • X. Xie
  • L. Li
  • C. Xu
  • L. Shen
  • L. Gu
Original Article

DOI: 10.1007/s10067-004-1065-6

Cite this article as:
Chen, J., Wang, Y., Kunkel, G. et al. Clin Rheumatol (2005) 24: 464. doi:10.1007/s10067-004-1065-6
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Abstract

We report on the unique effects and benefits of autologous stem cell transplantation in childhood systemic lupus erythematosus (SLE) and describe this procedure in two young girls with severe and refractory disease. The patients’ stem cells were mobilized with granulocyte colony-stimulating factor (G-CSF) and collected by CS-3000 Blood Cell Separator (Baxter Healthcare, Round Lake, Ill., USA), and the CliniMACS CD34+ cell selection device (Miltenyi Biotech, Bergisch Gladbach, Germany) was used to obtain CD34+ cells. A total of 1.7×106 and 1.0×106/kg CD34+ cells were obtained, with 2.0×105 and 1.0×104/kg of CD3+ cells remaining, respectively. The conditioning regimen consisted of cyclophosphamide (50 mg/kg per day for 4 days) plus antithymocyte globulin (ATG-Fresenius, 5 mg/kg per day for 3 days). Neutrophil counts recovered within 9 days in both cases. Within 15 days, the platelet counts recovered and were sustained over 100×109/l. Cushingoid features disappeared completely 3 months after transplantation because of the removal of corticosteroid medication. One 13-year-old child increased her height by 5 cm in 6 months after stopping steroids. She had not increased her height in her previous 7 years of disease. As of the time of this report, the first patient remains in clinical and laboratory remission for nearly 4 years, while the second suffered a relapse of thrombocytopenia 9 months post-transplantation. One residual effect of their treatment is that their CD4+ cell counts remained in the lower range after one year of transplant. The effect of this conditioning regimen plus CD34+ autologous stem cell transplantation on these two children with refractory SLE was beneficial, but long-term follow-up data and additional experience with this procedure are required. Autologous stem cell transplantation may limit the long-term toxicity of therapy in childhood SLE.

Keywords

Autologous stem cell transplantation Children SLE 

Copyright information

© Clinical Rheumatology 2005

Authors and Affiliations

  • J. Chen
    • 1
  • Y. Wang
    • 1
  • G. Kunkel
    • 2
  • H. Zhao
    • 1
  • H. Xue
    • 1
  • X. Xie
    • 1
  • L. Li
    • 1
  • C. Xu
    • 1
  • L. Shen
    • 1
  • L. Gu
    • 1
  1. 1.Department of Hematology/Oncology, Xinhua Hospital/Shanghai Children’s Medical CenterShanghai Second Medical UniversityShanghaiChina
  2. 2.Division of RheumatologyUniversity of Utah Health Sciences CenterSalt Lake CityUSA

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