From the Guidelines
Stem cell transplants can be a viable option for managing systemic inflammation in specific conditions, particularly in autoimmune diseases where conventional treatments have failed, as evidenced by a recent study published in 2025 1.
Key Considerations
- The decision to undergo a stem cell transplant should be made on a case-by-case basis, taking into account the individual's overall health, disease severity, and potential risks associated with the procedure.
- For conditions like multiple sclerosis, autologous hematopoietic stem cell transplantation (AHSCT) has shown promise in reducing inflammation and disease activity, especially in patients with relapsing-remitting MS or those with early progressive MS and evidence of inflammatory disease 1.
- The procedure involves collecting the patient's own stem cells, administering chemotherapy to eliminate problematic immune cells, and then reinfusing the collected stem cells to rebuild a healthier immune system.
- However, stem cell transplants carry significant risks, including infections during recovery, graft-versus-host disease, and potential organ damage from conditioning regimens, highlighting the need for careful patient selection and monitoring 1.
Recent Evidence
- A 2025 study published in Nature Reviews Neurology provides recommendations for the use of AHSCT in treating multiple sclerosis and neuromyelitis optica spectrum disorder, emphasizing the importance of individualized assessment and consideration of factors such as age, disease duration, and cognitive impairment 1.
- Another study published in 2023 in Nature Reviews Rheumatology discusses the state-of-the-art evidence in treating systemic sclerosis, highlighting the potential benefits of AHSCT in improving survival for patients with early diffuse cutaneous SSc who are at high risk of mortality 1.
Clinical Implications
- Stem cell transplants should be considered as a treatment option for systemic inflammation in specific conditions, such as autoimmune diseases, where conventional treatments have failed.
- The decision to undergo a stem cell transplant should be made in consultation with a specialized healthcare team, taking into account the individual's unique circumstances and potential risks associated with the procedure.
- Further research is needed to fully understand the benefits and risks of stem cell transplants in managing systemic inflammation and to identify the most suitable candidates for this treatment option.
From the Research
Systemic Inflammation and Stem Cell Transplants
- Systemic inflammation can be a symptom of various autoimmune diseases, and stem cell transplants have been explored as a potential treatment option 2, 3, 4.
- Autologous haematopoietic stem cell transplantation (HSCT) has been shown to induce long-term, drug-free and symptom-free remission in several refractory autoimmune rheumatic diseases 2.
- Allogeneic hematopoietic stem cell transplantation may be a therapeutic option for systemic autoinflammatory diseases (AIDs), particularly if response to conventional treatments is lacking 3.
- The aim of HSCT is to 'reset' one's immune system into a naïve and self-tolerant state through immune depletion and regulation, which can help reduce systemic inflammation 4.
Efficacy of Stem Cell Transplants
- Mesenchymal stem cell (MSC) transplantation has been shown to be effective in reducing disease activity and improving clinical symptoms in various autoimmune diseases, including rheumatoid arthritis, systemic lupus erythematosus, and inflammatory bowel disease 5.
- MSC transplantation may also improve clinical efficacy and reduce inflammation in ankylosing spondylitis and multiple sclerosis, although more research is needed to confirm these findings 5.
- The efficacy of stem cell transplants in reducing systemic inflammation may depend on the specific disease being treated, as well as the conditioning regimen and donor type used 2, 3.
Safety and Risks
- Stem cell transplants can be associated with risks, including transplant-related mortality (TRM) and graft-versus-host disease (GvHD) 2, 3.
- However, MSC transplantation has been shown to be safe and well-tolerated, with no obvious adverse events reported in clinical trials 5.
- Careful patient selection, close collaboration between physicians, and expertise of the transplant team are essential to ensure optimal outcomes and minimize risks 2, 4.