When people with severe lupus have failed other treatment options, their stem cells may help save their lives.
The finding, published in The Journal of the American Medical Association, doesn’t amount to a cure for lupus, a disease of the immune system.
However, half of the study’s 48 patients who got the procedure lived five more years without lupus, and even more (84 percent) survived for at least five years even if they didn’t have complete remission.
The researchers included Richard Burt, MD, of the immunotherapy department at Northwestern University’s medical school.
The procedure has risks but deserves more study, notes an editorial in the journal.
Rebooting Stem Cells
In Burt’s study, all patients had severe lupus that threatened their lives or organs. They had already unsuccessfully tried standard treatments.
The researchers removed some of the patients’ stem cells and then rebooted those stem cells in a lab. The type of stem cell that was involved makes white blood cells, a tool of the immune system.
The immune system is supposed to defend the body from invaders such as viruses. In autoimmune diseases like lupus, the immune system attacks the body instead of protecting it.
The scientists’ goal: Spur the stem cells to make new white blood cells that don’t aggravate lupus when transplanted back into the patients.
Meanwhile, the patients took strong chemotherapy-like drugs to delete their old white blood cells. The strategy was to clear the decks, making way for the new (and hopefully improved) white blood cells. Lastly, the patients got their rebooted stem cells back.
Wiping out a person’s white blood cells leaves them vulnerable to infections until their white blood cell levels rise. Infections are one of the procedure’s risks, note Burt and colleagues.
They call for future studies that include a comparison group of patients that don’t undergo the procedure. Such studies would be helpful, agree editorialists Michelle Petri, MD, MPH, and Robert Brodsky, MD, of Johns Hopkins University’s medical school.
By Miranda Hitti, reviewed by Louise Chang, MD
SOURCES: Burt, R. The Journal of the American Medical Association, Feb. 1, 2006; vol 295: pp 527-535. Petri, M. The Journal of the American Medical Association, Feb. 1, 2006; vol 295: pp 559-560. WebMD Medical Reference from Healthwise: “Lupus (Systemic Lupus Erythematosus): Topic Overview.” News release, JAMA/Archives.