This study will explore a new approach to treat patients with a medical condition known as systemic lupus erythematosus (SLE) who have been resistant to previous treatments using a new population of cells with capability to restore a normal immune system that will no longer attack the body.
The stated hypothesis is that the SLE condition is caused by an abnormal immune system that can be restored by replenishing the body with a new population of progenitor cells.
Primary Outcome Measures:
- Systemic Lupus Erythematosus Disease Activity Index (SLEDAI) [ Time Frame: Monthly ] [ Designated as safety issue: Yes ]
- Lupus serology (ANA, dsDNA, C3, C4) [ Time Frame: Monthly ] [ Designated as safety issue: Yes ]
- Renal function (GFR, BUN, urinalysis) [ Time Frame: Monthly ] [ Designated as safety issue: Yes ]
Secondary Outcome Measures:
- Percentage of systemic T regulatory population [ Time Frame: Every 3 months ] [ Designated as safety issue: No ]
Estimated Enrollment: |
20 |
Study Start Date: |
March 2007 |
Estimated Study Completion Date: |
December 2012 |
Estimated Primary Completion Date: |
December 2011 (Final data collection date for primary outcome measure) |
1: Experimental
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Biological: Allogeneic MSC (AlloMSC)
Intervention:
Cyclophosphamide will be administered intravenously at at total dose of 0.8-1.8g 24 hours before transplantation.
Allogeneic bone marrow derived mesenchymal stem cells (matched family donors)will be infused intravenously at 106 cells/kg body weight
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The purpose of this study is to evaluate the safety and efficacy of allogeneic bone marrow derived mesenchymal stem cell (AlloMSC) transplantation in patients with refractory SLE. Patients with Lupus nephritis and refractory to corticosteroid or cyclophosphamide trials will be enrolled in this trial. The treatment intervention includes a 24 hour pretreatment with cyclophosphamide followed by AlloMSC transplantation. Patients will be admitted to the in-patient service for the 3-5 days for the transplant treatment and will be followed up in the outpatient clinic. All baseline lupus serology, renal function panels will be obtained at pre-treatment admission. Post-transplantation follow-up visits will be at monthly intervals for lupus serology and renal function tests, and every 3 months for analysis of T regulatory population. The transplanted patients will be evaluated by an integrated team of rheumatologists, hematologists and bone marrow transplant specialists every month for the entire duration of the trial (2 years) and every 6-12 months thereafter.