Autotrapianto di linfociti come nuova opzione terapeutica nell'artrite cronica giovanile intrattabile

There is clinical evidence that allogeneic bone marrow transplantation can cure autoimmune diseases and that autologous bone marrow transplantation can induce a long lasting remission. We submitted to this procedure three patients with intractable juvenile chronic arthritis. The aim of our procedure was to achieve an immune tolerance by incubating the patient's lymphocytes with vincristine and methylprednisolone without T depletion. We used an immunosuppressive therapy with cyclophosphamide at a lower dosage than the traditional autologous transplantation. All the patients achieved a profound clinical remission associated with a normalization of laboratory inflammatory indexes. One patient relapsed after 8 months and the others two are in partial remission after 5 months. In conclusion, the autologous BMT is a rational therapeutic option, able to induce a profound remission in severe, refractory autoimmune diseases. We would stress that our procedure was well tolerated by the patients and has negligible risks.