Induction of remission of severe and refractory rheumatoid arthritis by allogeneic mixed chimerism

Richard K. Burt*, Yu Oyama, Larissa Verda, Kathleen Quigley, Mary Brush, Kimberly Yaung, Laisvyde Statkute, Ann Traynor, Walter G. Barr

*Corresponding author for this work

Research output: Contribution to journalArticle

79 Scopus citations

Abstract

This report describes the first allogeneic hematopoietic stem cell transplantation (HSCT) performed for the indication of rheumatoid arthritis (RA). We used nonmyeloablative allogeneic HSCT to treat a 52-year-old woman who had treatment-refractory RA and a poor prognosis (24 swollen and 38 involved joints). She was treated with fludarabine, cyclophosphamide, CAMPATH-1H, and CD34-selected HSCT (8 million CD34+ donor cells/kg); the donor was the patient's HLA-matched, rheumatoid factor-negative sister. One year post-HSCT, the patient has had no infection except dermatomal varicella-zoster virus infection and no acute or chronic graft-versus-host disease (GVHD). Her RA has remained in remission with no immunosuppressive or immunomodulatory medications. The patient is a mixed chimera, with 55% donor T (C133+) cells and 70% donor myeloid (CD33+) cells. This is the first published report of allogeneic HSCT performed for the indication of RA. Mixed chimerism has resulted in marked amelioration of RA, without GVHD.

Original languageEnglish (US)
Pages (from-to)2466-2470
Number of pages5
JournalArthritis and rheumatism
Volume50
Issue number8
DOIs
StatePublished - Aug 2004

ASJC Scopus subject areas

  • Immunology and Allergy
  • Rheumatology
  • Immunology
  • Pharmacology (medical)

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    Burt, R. K., Oyama, Y., Verda, L., Quigley, K., Brush, M., Yaung, K., Statkute, L., Traynor, A., & Barr, W. G. (2004). Induction of remission of severe and refractory rheumatoid arthritis by allogeneic mixed chimerism. Arthritis and rheumatism, 50(8), 2466-2470. https://doi.org/10.1002/art.20451