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Stem Cell Transplants are still in the experimental stage as a
treatment for lupus.
Stem Cells are the undifferentiated, or immature blood cells,
that turn into mature cells in the bone marrow. This treatment has
been used in cancer treatments for 20 years, notably aplastic anemia,
but the application in other autoimmune disorders such as Multiple
Sclerosis, and Lupus, is relatively recent and heavily experimental.
The treatment works on the principle that once the immune system
slate is wiped clean, the body can re-learn how to defend itself
properly again.
In people with autoimmune disorders, the immune system attacks
its own tissues and organs and must be re-taught to differentiate
between the body's own cells and foreign attackers. "This therapy
is analogous to rebooting a computer -- you wipe out the old information,
then allow it to re-learn. The immune system that returns should
function normally,". -Richard Jones, M.D., Director of Bone Marrow
Transplantation, Johns Hopkins
First, a source of potentially health cells must be found. Two
approaches are to use the patient's own cells (auto-logous), and
to find a suitable donor (allo-genic). Many think the allogenic
donation is preferable, because that way the patient can start with
a completely clean slate. The stem cells are conditioned to purge
most of the immune cells. To eliminate the wayward cells, either
high-dose cytotoxic (cell-killing) medications are used, or total-body
radiation. Then the donated cells are reinfused into the body, and
the process of re-keying the immune system hopefully begins.
Even to be considered for this treatment, the patient must have
failed to benefit from all other conventional therapies. It must
be a matter of life and death. However, at the same time, the patient
must be able to tolerate the treatment. For example, at South Texas
Cancer Treatment Institute, here are the eligibility criteria for
being accepted on autoimmune protocols:
Lupus:
Less than 60 years of age.
Established clinical diagnosis with one of the following malignant
features:
nephritis
vasculitis/immune complex deposition
hematologic cytopenias
catastrophic anti-phospholipid syndrome
The medications used are extremely toxic, and complications leading
to a lengthy hospitalization can result. As with any radical treatment,
a small number of patients could even die from treatment-related
complications. The treatments is very expensive, and most likely
not covered by insurance. However, on an individual basis, some
are getting coverage, or getting drug companies to donate medications.
The Kiel Research Group for Autoimmune diseases has an interesting
explanation for why there is no way at present to define cure in
terms of SLE. Up until this point, there hasn't been a need to define
cure, because a cure has not been possible. However, with the increasing
activity on the stem cell transplant front, they have petitioned
the American College of Rheumatology (ACR) to define a cure for
lupus in these terms:
Long-term and treatment-free complete clinical remision with restoration
of normal blood counts and a normal immune system.
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