Autologous blood stem cell transplantation in refractory systemic lupus erythematosus with severe pulmonary impairment: A case report

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Abstract
For patients with severe forms of autoimmunity, including systemic lupus erythematosus (SLE), purging autoreactive T cells from the immune repertoire by transplanting autologous hematopoietic stem cells (ASCT) is a therapeutic option. We describe an 18‐year‐old woman with SLE who had been treated with corticosteroids, azathioprine, cyclophosphamide (CYC), and immunopheresis for 4 years, during which time mechanical ventilation for lupus pneumonitis had been repeatedly required. After the patient was conditioned by administration of CYC and antithymocyte globulin, a total of 8.87 × 106 purified CD34+ cells per kg of body weight was infused. Hematopoietic regeneration was observed within 9 days. Twenty‐one months after ASCT, the patient continues to be in complete clinical remission, with no signs of SLE‐related disease activity and without any immunosuppressive medications. Her pulmonary function has returned to normal. Although a longer followup is required for assessment of the durability of response, the patient's course indicates that ASCT may be a way to reinduce tolerance in patients with SLE.

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