rocess that usually requires a few weeks of hospitalization, patients immune systems were virtually destroyed through high doses of chemotherapy. Then the cleansed stem cells were returned to the bone marrow to repopulate the marrow and body in an effort to regenerate a healthier immune system. "The idea is that if you turn back the clock and let the immune system heal itself, the patient should have a chance of ending up without the disease," says Dr. Burt.

A European multi-center trial published in 2004 reported a similar success rate; however the treatment-related mortality rate was much higher at 13 percent, compared to a 2 percent rate in this study. The authors note that the toxicity of the treatment is a result of patient selection, the conditioning regimen and supportive care during and after transplantation. "It is doubtful our lower treatment mortality rate was due to patient selection, as our patients were very ill," says co-author Yu Oyama, MD, an autoimmune disease specialist at Northwestern Memorial Hospital and assistant professor, Division of Immunotherapy for Autoimmune Diseases at the Feinberg School of Medicine.

"A center effect on survival has also been reported for stem cell transplantation in malignancies," says Dr. Burt. "However, it's important to note that the patients in this study are not comparable to those with malignancies. The patients in this study had organ dysfunction and were immunocompromised for a long time, conditions which often rule out stem cell transplant for cancer patients because it would be too dangerous. This highlights the importance for a medical center to have experience when treating lupus patients with high-dose chemotherapy and stem cell transplant."

Lupus is a chronic, inflammatory, autoimmune disease that mainly affects women of child-bearing age. Its symptoms range from unexplained fever, swollen joints and skin rashes to severe damage of the kidneys, lungs or central nervous
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Contact: Amanda Widtfeldt
awidtfel@nmh.org
312-926-2955
Northwestern Memorial Hospital
31-Jan-2006

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