Autologous haematopoietic stem cell transplantation: a viable treatment option for CIDP

Abstract

Our results though hampered by the limited number of patients and the lack of a control group suggest AHSCT to be efficacious in therapy-refractory CIDP, with a manageable complication profile. Confirmation of these results is necessary through randomised controlled trials.

New Insights Into the Management of Chronic Inflammatory Demyelinating Polyradiculoneuropathy

“…Considerable benefits with cyclophosphamide [18,19] and cyclosporine [20] were reported in small case series of patients with refractory CIDP, but the lack of new data in the past decade suggests that other research avenues are preferred. Autologous hematopoietic stem cell transplantation induced long-term drug-free remission in 8 of 11 patients with therapy-refractory CIDP [21], but application of the procedure is limited by the risk of associated infections. Numerous biological agents directed against T cells, B cells and transmigration and transduction molecules (e.g., alemtuzumab, eculizumab, etanercept, fingolimod, natalizumab, rituximab and tacrolimus) have been investigated, with review Rajabally, Blomkwist-Markens & Katzberg future science group varying degrees of success [2,[16][17].…”

Ultrasonography-guided transplantation facilitates perineural delivery of stem cells

“…Clinically, administration of autologous peripheral blood stem cell have been tried; however, the efficacy could not be sufficiently assessed due to the limited number of patients and the lack of a control (Press et al 2014;Mahdi-Rogers et al 2009). Conversely, human bone-marrow-derived MSCs have been intravenously injected into mouse models of experimental autoimmune myasthenia gravis, and exhibited potential therapeutic efficacy (Yu et al 2010).…”

Devastating humoral CIDP variant remitted by autologous stem cell transplantation

“…Long‐lived memory plasma cells within the bone marrow are a known source of auto‐reactive antibodies and can be eradicated by autologous and allogeneic stem cell transplantation. The latter approaches achieved partial and full remission, even in CIDP patients , but their mechanisms of immune system recovery remain incompletely understood. Here, we assume an ASCT‐mediated abrogation of pathogenic antibody synthesis by normalization of increased plasmablast frequencies in blood after ASCT and/or depletion of long‐lived plasma cells, as indirectly implied by decrease of vaccine‐specific antibodies.…”

“…Moreover, CD4 + and CD8 + T-cell effector memory cells (CD45RA À CCR7 À ) potentially reflecting chronic autoimmune reactions also normalized after ASCT. [4,5], but their mechanisms of immune system recovery remain incompletely understood. Here, we assume an ASCTmediated abrogation of pathogenic antibody synthesis by normalization of increased plasmablast frequencies in blood after ASCT and/or depletion of long-lived plasma cells, as indirectly implied by decrease of vaccine-specific antibodies.…”