STEM CELL TRANSPLANTATION AS A POSSIBLE STRATEGY FOR TREATING STANDARD THERAPY-RESISTANT ANKYLOSING SPONDYLITIS

I Z Gaidukova,V V Ushakova,A P Rebrov

doi:10.14412/1996-7012-2016-4-87-91

Abstract

The authors have analyzed the literature dealing with studies of the efficiency and safety of stem cell transplantation (SCT) in patients with ankylosing spondylitis (AS) through the electronic resources Pubmed and Medline by using the keywords «bone marrow transplantation», «hematopoietic stem cell transplantation», «ankylosing spondylitis», «autoimmune diseases», and «sacroiliac joint biopsy». The paper describes four cases of SCT in AS patients, including transplantation that was carried out in one patient with lymphoma concurrent with AS, in two AS patients without blood cancers, and in one patient with AS concurrent with myeloid leukemia. Drug-free remission was achieved in 3 cases: lymphoma concurrent with AS (n=1), AS concurrent with myeloid leukemia (n=1), and AS without comorbidities (n=1). In addition to an improvement in the course of AS, there were also two cases with clinical presentations of AS after SCT. The given cases show that SCT can be basically used to induce drug-free remission in patients with severe forms of standard therapy-resistant AS. However, the introduction of SCT in clinical practice needs to adjust the technique to the specific features of AS patients.

Highlights

Stem cell transplantation as a possible strategy for treating standard therapy-resistant ankylosing spondylitis Gaidukova I.Z., Ushakova V.V., Rebrov A.P
The authors have analyzed the literature dealing with studies of the efficiency and safety of stem cell transplantation (SCT) in patients with ankylosing spondylitis (AS) through the electronic resources Pubmed and Medline by using the keywords «bone marrow transplantation», «hematopoietic stem cell transplantation», «ankylosing spondylitis», «autoimmune diseases», and «sacroiliac joint biopsy»
Drug-free remission was achieved in 3 cases: lymphoma concurrent with AS (n=1), AS concurrent with myeloid leukemia (n=1), and AS without comorbidities (n=1)

Summary

Introduction

Stem cell transplantation as a possible strategy for treating standard therapy-resistant ankylosing spondylitis Gaidukova I.Z., Ushakova V.V., Rebrov A.P. Указанные выше недостатки существующих методов лечения АС определяют необходимость рассмотрения принципиально новых подходов к лечению, среди которых на первый план выступают генно-инженерные технологии, направленные на изменение особенностей транскрипции ряда генов и работы сигнальных молекул, ответственных за реализацию воспалительного и пролиферативного процесса при АС, а также трансплантация стволовых клеток (ТСК) костного мозга. У пациента с высокой активностью АС была выполнена аутологичная трансплантация ГСК по поводу лимфомы, что привело к изменению клинической картины заболевания: наступила ремиссия, а признаки активного АС с течением времени исчезли.

Results

Conclusion