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International Journal of Hematology

, Volume 78, Issue 5, pp 453–456 | Cite as

Autologous Hematopoietic Stem Cell Transplantation for 3 Patients with Severe Juvenile Rheumatoid Arthritis

  • Tomoko Kishimoto
  • Takashi Hamazaki
  • Masahiro Yasui
  • Makoto Sasabe
  • Takayuki Okamura
  • Naoki Sakata
  • Masami Inoue
  • Keiko Yagi
  • Keisei Kawa
Case Report

Abstract

We performed autologous CD34+ stem cell transplantation in 3 patients with juvenile rheumatoid arthritis (JRA) refractory to conventional treatment. All patients had systemic type JRA. In case 1 (a 3-year-old boy), purified CD34+ cells from bone marrow were transplanted after a preconditioning regimen consisting of cyclophosphamide (200 mg/kg) and antithymocyte globulin (ATG) (40 mg/kg). However, the disease flared soon after transplantation. In case 2 (a 13-year-old girl) and case 3 (a 21-year-old woman), a preconditioning regimen consisting of etoposide (VP16) (2 g/m2), thiotepa (300 mg/m2), and ATG (40 mg/kg) was followed by transplantation of purified CD34+ stem cells harvested from peripheral blood mononuclear cells. The patients in cases 2 and 3 attained complete remission without any medication. Thus for patients with refractory JRA, autologous CD34+ cell transplantation appears to be a safe and feasible choice of treatment in terms of good quality of life. However, a greater number of patients and a longer observation period are needed before definitive conclusions can be drawn.

Key words

JRA CD34+ selection Autologous hematopoietic stem cell transplantation 

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Copyright information

© The Japanese Society of Hematology 2003

Authors and Affiliations

  • Tomoko Kishimoto
    • 1
    • 2
  • Takashi Hamazaki
    • 1
  • Masahiro Yasui
    • 1
  • Makoto Sasabe
    • 1
    • 3
  • Takayuki Okamura
    • 1
  • Naoki Sakata
    • 1
  • Masami Inoue
    • 1
  • Keiko Yagi
    • 1
  • Keisei Kawa
    • 1
  1. 1.Department of PediatricsOsaka Medical Center and Research Institute for Maternal and Child HealthOsakaJapan
  2. 2.Department of PediatricsNara Medical UniversityNara
  3. 3.Department of PediatricsOkayama University of MedicineOkayamaJapan

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