Hematopoietic stem cell transplantation for non-malignant gastrointestinal diseases

Both,autologous and allogeneic hematopoietic stem cell transplantation(HSCT)can be used to cure or ameliorate a variety of malignant and non-malignant diseases.The rationale behind this strategy is based on the concept of immunoablation using high-dose chemotherapy,with subsequent regeneration of naive T-lymphocytes derived from reinfused hematopoietic progenitor cells.In addition,the use of HSCT allows for the administration of high-dose chemotherapy(whether or not combined with immunomodulating agents such as antithymocyte globulin)resulting in a prompt remission in therapy-refractory patients.This review gives an update of the major areas of successful uses of HSCT in non-malignant gastrointestinal disorders.A Medline search has been conducted and all relevant published data were analyzed.HSCT has been proved successful in treating refractory Crohn’s disease(CD).Patientswith refractory celiac disease typeⅡand a high risk of developing enteropathy associated T-cell lymphoma have shown promising improvement.Data concerning HSCT and mesenchymal SCT in end-stage chronic liver diseases are encouraging.In refractory autoimmune gastrointestinal diseases high-dose chemotherapy followed by HSCT seems feasible and safe and might result in long-term improvement of disease activity.Mesenchymal SCT for a selected group of CD is promising and may represent a significant therapeutic alternative in treating fistulas in CD.