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La prática del trasplante de células progenitoras para las enfermedades autoinmunitarias severas refractarias a terapia convencional parte de dos descubrimientos: los excelentes resultados de los experimentos animales, y las observaciones descubiertas en humanos con enfermedades coincidentes. Los datos de los estudios experimentales y en fase temprana I-II en algunos pacientes altamente seleccionados sugieren que la quimioterapia a dosis elevadas seguidas por trasplante autólogo de progenitores hematopoyéticos (TPH) puede detener la progresión de enfermedades autoinmunitarias (EAI) severas con un aceptable riesgo/beneficio. En este artículo revisamos los ensayos en fase II-III prospectivos, multicéntricos, aleatorizados en diferentes EAI. Por otra parte, el trasplante alogénico de células progenitoras para EAI está siendo cautelosamente explorado en protocolos actuales.
Palabras clave:
Trasplante
Células progenitoras
Enfermedades autoinmunitarias
The use of stem cell transplantation for severe autoimmune diseases refractory to conventional therapy arose from two discoveries: the excellent results of animal experiments, and serendipitous observations in human coincidental diseases. Experimental data and early phase I-II trials in highly selected patients suggest that highdose chemotherapy followed by autologous hematopoietic stem cell transplantation can arrest progression of severe autoimmune diseases with an acceptable risk/benefit ratio. The present article reviews the phase II-III prospective, multicenter, randomized trials that have been performed in distinct autoimmunediseases. In addition, allogeneic stem cell transplantation for autoimmune diseases is being cautiously explored in current protocols.
Key words:
Transplantation
Stem cell
Autoimmune diseases
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