Pemphigus vulgaris treated with allogeneic hematopoietic stem cell transplantation following non-myeloablative conditioning

Objectives: Successful treatment of severe, refractory Pemphigus vulgaris (PV) is reported. Methods: Reduced intensity, non-myeloablative conditioning was employed, followed by allogeneic hematopoietic stem cell transplantation (HSCT) from a fully matched sibling. Results: Treatment of refractory PV with myeloablation and subsequent allogenic HSCT has been previously reported, and sustained remission with this approach has been achieved. Toxicity, however, related to condition regimens remains high. Conclusion: Since no cytotoxic chemotherapy was used, it is hereby hypothesized that clinical improvement may result from regulatory action from the donor's marrow: a "graft modifying the disease" effect, which may prove useful in the management of autoimmune diseases.