Thursday, October 04, 2007

REPORT: CELIAC DISEASE REVERSED AFTER STEM CELL TRANSPLANT

The October 2007 issue of Pediatrics—the official journal of the American Academy of Pediatrics—offers a case report entitled "Correction of Celiac Disease After Allogeneic Hematopoietic Stem Cell Transplantation for Acute Myelogenous Leukemia."

It's a fascinating glimpse into the world of Hematopoietic Stem Cell Transplantation (HSCT). Did you know that, as the authors note, there are documented cases of patients developing celiac disease due to stem cells from donors who have celiac disease, but that this case report might be the first to describe a "cure" of the condition due to a stem cell transplant? Or that there has been documentation of improvement or stabilization of systemic lupus erythematosus, rheumatoid arthritis, multiple sclerosis, and Crohn's disease after stem cell transplantation?

The report concludes
Although we do not, at this time, advocate allogeneic HSCT as the definitive treatment of CD, the decreased morbidity and mortality associated with the use of reduced-intensity stem cell transplants may someday allow HSCT to be an acceptable alternative to a lifelong gluten-restricted diet, which, at best, is extremely difficult to remain adherent to for life. Whether HSCT will reduce the purportedly increased risk of enteric malignancy in this population remains unclear.
My reaction to this is mixed. I'm fascinated by the thought that HSCT might reverse celiac disease, but I'm also skeptical about this isolated case. There have been tales of remission before, especially for people in this patient's age group. Further monitoring and more research should shed light on what sounds like a very promising medical development.

3 comments:

Freestyle Pete said...

Being a RN with CD I would have to see a larger number of people in the study. Lets wait and see

Nicole said...

It certainly supports the concept of an association between lymphomas and CD (ie that whatever autoimmune process causes one could also be involved in the other). I do have mixed feelings as well about pursuing HSCT as a CD cure. I mean, imagine going through the hell of transplant. I don't think I could put myself through that unless it was absolutely necessary for survival. It's fascinating...

ben cappel said...

i think the idea of "immune system programming" is fascinating. could there be some way of modifying the immune system's response to certain triggers using stem cells/some other technique? to me, it's a very exciting thought...