Haematopoietic stem cell transplantation for autoimmune diseases

Haematopoietic stem cell transplantation (HSCT) requires a careful selection of patients according to autoimmune disease, and a consideration of therapeutic alternatives, risks and benefits, and the expertise of the transplantation teamThe need for graft manipulation before HSCT is uncertainIndividualized conditioning regimens might provide increased long-term remission rates, and stem cell rescue could minimize the duration of neutropenia and improve the containment of virusesHSCT resets the immune system by renewing the CD4+ T cell compartment, especially within the Treg cell population, and by restoring T cell receptor diversity and functionIn patients with systemic sclerosis, HSCT results in increased mortality within the first year but a considerable long-term, event-free survival benefit afterwards