1 The Outcome of Intensive Immunosuppression and Autologous Stemcell Transplantation in Patients with Severe Rheumatoid Arthritis is Associated

High dose chemotherapy (HDC) followed by autologous stem cell transplantation (ASCT) is an experimental treatment modality for patients with severe autoimmune diseases including refractory rheumatoid arthritis (RA). It is aimed at immunoablation to allow regeneration of a non-autoaggressive immune system from reinfused stem cells. This study was undertaken to determine clinical and immunological correlates of HDC + ASCT in patients with severe rheumatoid arthritis (RA), refractory to conventional therapy. Methods. Seven RA patients treated with HDC and autologous peripheral blood grafts enriched for CD34+ cells underwent serial sampling of peripheral blood and synovial tissue specimens. Disease activity was assessed with disease activity scores (DAS), serum concentrations of C-reactive protein (CRP) , and human immunoglobulin (HIG)-scans, while the extent of immunoablation was determined by immunophenotyping of peripheral blood mononuclear cells and immunohistochemistry and double immunofluorescence of synovium. Results