High-dose immune suppression and autologous hematopoietic stem cell transplantation in refractory Crohn disease |
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Authors: | Burt Richard K Traynor Ann Oyama Yu Craig Robert |
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Affiliation: | Division of Immunotherapy, Northwestern University Medical School, Chicago, IL 60611, USA. rburt@nwu.edu |
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Abstract: | Two patients with severe Crohn disease, defined by a Crohn Disease Activity Index (CDAI) higher than 250 despite anti-tumor necrosis factor alpha (TNF-alpha), were treated by intense immune suppression and autologous hematopoietic stem cell transplantation (HSCT). Stem cells were mobilized from the peripheral blood using cyclophosphamide (2.0 g/m2) and granulocyte colony-stimulating factor (G-CSF; 5 micro g/kg/d), enriched ex vivo by CD34+ selection, and reinfused after immune conditioning with cyclophosphamide (200 mg/kg) and equine anti-thymocyte globulin (ATG; 90 mg/kg). Patients have remained in remission (CDAI < 100) for 1 year since HSCT. We conclude that further HSCT studies for severe Crohn disease appear warranted. |
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