Cattedra e Clinica di Reumatologia, Policlinico Universitario, P.zza S. Maria Misericordia 1, 33100 Udine, Italy.
New therapeutics have clearly advanced our chances of inducing remission in several aggressive autoimmune diseases like rheumatoid arthritis (RA) or systemic lupus erythematosus (SLE).
Despite this, subgroups of patients with RA or SLE or of other diseases like systemic sclerosis (SSc) or multiple sclerosis (MS) still present a poor response to conventional drugs.
In this kind of patients, haematopoietic stem cell transplantation (HSCT) provided important clinical benefits in several studies.
This might depend upon several possible mechanisms such as purging of autoreactive T cells during conditioning or changes of the TH1/TH2 biological milieu.
An overview of the results obtained so far, the drawbacks and the perspectives in this field are presented.