Remission of Sclerosis After Bone Marrow Transplant

Bone marrow cell transplantation can result in sustained remission of severe systemic sclerosis, according to a new study.

Researchers at the Fred Hutchinson Cancer Research Center (Seattle, WA, USA) performed allogeneic hematopoietic cell transplantation (HCT) in two patients with diffuse cutaneous systemic sclerosis and lung involvement who did not respond to conventional immunosuppressive treatment.

In the first patient, a 38-year-old woman, there were no complications related to the conditioning regimen and no problems with graft versus host disease (GVHD). At five years after HCT, the patient had almost complete resolution of the scleroderma and marked improvement in physical functioning. Her lung condition also improved. Skin biopsy showed resolution of dermal fibrosis. The second patient, a 31-year-old woman, had skin toxicity probably related to the conditioning regimen and a hypertensive crisis that may have been brought about by use of corticosteroids for GVHD. Despite this, she showed improvement in scleroderma and overall functioning, but 18 months after HCT she presented to a local hospital with overwhelming sepsis and died. Death was secondary to pneumonia, with blood cultures positive for Pseudomonas aeruginosa. The results were reported in the June 2006 issue of Arthritis and Rheumatism

"Although there is a risk, the potential benefit of allogeneic hematopoietic cell transplantation is durable disease remission that may improve quality of life and overall function,” said lead investigator Dr. Richard A. Nash. "This is the first report that the fibrotic changes in the skin associated with systemic sclerosis are reversible.”


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Fred Hutchinson Cancer Research Center