Abstract:We treated 2 patients with progressive, refractory scleroderma with a combined immunotherapy approach using plasmapheresis followed by rituximab and then intravenous umbilical-cord-derived allogeneic mesenchymal stem cells (MSCs). Both patients improved subjectively and objectively for over a year. Upon recurrence of their symptoms, the patients were treated again with allogeneic MSCs alone with a very good response. The combination was well tolerated and effective suggesting a large scale study may be warranted in progressive, refractory Scleroderma.