Hematopoietic Stem Cell Transplantation And Cellular Therapies For Autoimmune Diseases

This book summarizes the global progress in medical and scientific research toward converting traditionally chronic autoimmune diseases into a drug-free reversible illness using hematopoietic stem cell transplantation (HSCT) and other cellular therapies such as T regulatory cells (Treg), mesenchymal stromal/stem cells, and chimeric antigen receptor T (CAR T) cells in order to reintroduce sustained immune tolerance. This title provides information on different types of stem cells and immune cells; post-transplant immune regeneration; cellular regulatory requirements; ethical and economic considerations; and the advantages and disadvantages of HSCT in the treatment of a variety of autoimmune diseases versus current conventional treatments. Arranged by disease, the text provides a comprehensive guide to HSCT for all types of autoimmune/immune disorders including monogenetic autoimmune diseases; autoimmune aplastic anemia; neurologic immune diseases including multiple sclerosis, chronic inflammatory demyelinating polyneuropathy, neuromyelitis optica, and stiff person syndrome; rheumatologic diseases such as systemic sclerosis and systemic lupus erythematosus; dermatologic diseases such as pemphigus; gastrointestinal disorders such as Crohn’s disease and celiac disease; and immune-mediated endocrinologic disease type I diabetes mellitus. Guidance is provided on the transplantation technique, cell collection and processing, conditioning regimens, infections, and early and late complications. Key Features Outlines therapies and techniques for HSCT for autoimmune diseases Discusses the advantages of HSCT over conventional therapies Reviews the entire process of stem cell therapy from harvest and ethics to indications, efficacy, and regulatory oversight

Stem cell transplantation may be complicated by treatment-related mortality and like the immune system that it regenerates has equal potential to either create and preserve or destroy. The dual nature that defines stem cells is differentiation that ultimately leads to death and self-renewal, which leads to immortality. What types of stem cells are there? How are they collected? What are their attributes and characteristics? This textbook devotes many chapters to familiarize the reader with the basic science, clinical aspects, and new questions being raised in the field of stem cell biology. Blood stem cells for tolerance and tissue regeneration are a rapidly developing research and clinical field that is being applied to autoimmune diseases. In clinical trials, autologous hematopoietic (blood) stem cells are being used to reduce the cytopenic interval following intense immune suppressive transplant regimens. While as yet not delineated, some possible mechanisms and pathways leading to tolerance after hematopoietic stem cell transplantation are suggested in these chapters. Tissue regeneration from blood stem cells is also suggested by animal experiments on stem cell plasticity or metamoirosis (i.e., change in fate) as described within this textbook. Ongoing early clinical trials on tissue regeneration from blood stem cells are described in the chapter on stem cell therapy for cardiac and peripheral vascular disease. Whether autologous hematopoietic stem cells, through the process of mobilization and reinfusion, may be manipulated to contribute to tissue repair in autoimmune diseases is a future area for translational research.

This book is open access under a CC BY 4.0 license. This textbook, endorsed by the European Society for Blood and Marrow Transplantation (EBMT), provides adult and paediatric nurses with a full and informative guide covering all aspects of transplant nursing, from basic principles to advanced concepts. It takes the reader on a journey through the history of transplant nursing, including essential and progressive elements to help nurses improve their knowledge and benefit the patient experience, as well as a comprehensive introduction to research and auditing methods. This new volume specifically intended for nurses, complements the ESH-EBMT reference title, a popular educational resource originally developed in 2003 for physicians to accompany an annual training course also serving as an educational tool in its own right. This title is designed to develop the knowledge of nurses in transplantation. It is the first book of its kind specifically targeted at nurses in this specialist field and acknowledges the valuable contribution that nursing makes in this area. This volume presents information that is essential for the education of nurses new to transplantation, while also offering a valuable resource for more experienced nurses who wish to update their knowledge.

Non-myeloablative allogeneic stem cell transplantation (also known as mini-transplantation or reduced-intensity conditioning transplantation) is a major advance in the field of hematopoietic transplantation within the last 5 years. This approach uses non-cytotoxic or reduced-intensity cytotoxic therapy to prepare patients for allografting of hematopoietic stem cells and lymphocytes. It has the potential to deliver the potent anti-tumor immunotherapy and bone marrow replacement capacity of allogeneic stem cell transplantation to patients with reduced treatment-related morbidity and mortality. It may also enable allogeneic transplantation in patients who would be considered ineligible for conventional transplants because of co-morbidity or advanced age. However, this approach may necessitate more careful monitoring of post-transplant chimerism and malignant disease-status than is usual with conventional allografting. There is also controversy regarding the best preparative regimen and graft-versus-host disease prophylaxis to use.

This book introduces many new technologies and clinical applications of hematopoietic stem cells and mesenchymal stem cell transplantation for the treatment of autoimmune diseases and inflammatory diseases. Presented in two parts, Part 1 focuses on stem cell therapies for autoimmune disease treatment; Part 2 focuses on stem cell therapies and their application in the treatment of common inflammatory diseases, including chronic knee osteoarthritis, chronic obstructive pulmonary disease, liver cirrhosis, Crohn's Disease, Multiple Sclerosis, and more. This book is an essential source for all advanced students and researchers involved with these diseases, stem cells, or both. Stem Cell Transplantation for Autoimmune Diseases and Inflammation and the other books in the Stem Cells in Clinical Applications series are invaluable to scientists, researchers, advanced students and clinicians working in stem cells, regenerative medicine, or tissue engineering as well as cancer or genetics research.

Autologous hematopoietic stem cell transplantation (AHSCT) was proposed 20 years ago as an alternative therapeutic approach for patients with severe and refractory autoimmune diseases. Since then, this innovative therapy has been successfully used to treat several autoimmune diseases, such as neurological disorders (Multiple Sclerosis), connective tissue diseases (Systemic Sclerosis and Systemic Lupus Erythematous), gastrointestinal inflammatory diseases (Crohn’s Disease) and others (Juvenile Arthritis, Type 1 Diabetes, Vasculitis). Experience in phase I-II and III clinical trials over the years has led to increased safety and efficacy of this procedure. Recent studies have demonstrated superior therapeutic efficacy of AHSCT versus conventional therapies, showing that transplantation can induce long-term disease remission in the absence of any further immunosuppressive treatment. Immune monitoring studies have showed that AHSCT is able to reduce the inflammatory milieu, to reset the immune balance and to promote the generation of a new auto-tolerant immune repertoire. However, some patients fail to remain in remission, and disease is re-activated after some time post-transplantation. This scenario indicates that further immunological interventions may be still required to improve AHSCT efficacy. Clear understanding of the operating immune mechanisms that contribute to specific clinical outcomes is vital to enable improvement of AHSCT protocols for autoimmune diseases.

Fully revised for the fifth edition, this outstanding reference on bone marrow transplantation is an essential, field-leading resource. Extensive coverage of the field, from the scientific basis for stem-cell transplantation to the future direction of research Combines the knowledge and expertise of over 170 international specialists across 106 chapters Includes new chapters addressing basic science experiments in stem-cell biology, immunology, and tolerance Contains expanded content on the benefits and challenges of transplantation, and analysis of the impact of new therapies to help clinical decision-making Includes a fully searchable Wiley Digital Edition with downloadable figures, linked references, and more References for this new edition are online only, accessible via the Wiley Digital Edition code printed inside the front cover or at www.wiley.com/go/forman/hematopoietic.