Clinical Reference

Blood Disorder Information

Comprehensive clinical information authored by Dr. Suparno Chakrabarti and Dr. Mahak Agarwal.

Thalassemia Sickle Cell Aplastic Anemia ALL AML CML CLL Hodgkin's NHL MDS Myeloma Autoimmune Immunodeficiency Metabolic BMF

Autoimmune Diseases

Adult BMT — Dr. Suparno Chakrabarti

Autoimmune Diseases (AID)

Autoimmune diseases are a group of diverse diseases caused by an abnormal immune response of the body against substances and tissues normally present in the body (autoimmunity). They usually occur in the early adulthood to middle age and are more common in females.

Examples of Autoimmune Diseases (AID)

  • Rheumatoid Arthritis
  • Systemic Lupus Erythematosus
  • Scleroderma
  • Juvenile Rheumatoid Arthritis
  • Vasculitis
  • Multiple Sclerosis
  • Autoimmune Hemolytic Anemia
  • Autoimmune Thrombocytopenia
  • Crohn's Disease etc.

What Causes Autoimmune Disease?

The cause of autoimmune disease is unknown. If one has a family member with an autoimmune disease, one may be more susceptible to developing the disease. There are many theories about what triggers autoimmune diseases, including: Bacteria / viruses; Drugs; Chemical irritants; Environmental irritants.

Treatment

They are usually treated with drugs that suppress the immune system such as steroids and other drugs.

How does Bone Marrow Transplantation (BMT) work in Autoimmune Disease?

This is possible in two different ways:

Autologous Bone Marrow Transplantation (BMT): The bone marrow and the immune system of the patient is killed with high dose chemotherapy. The stem cells of the patient, which are collected before the procedure, are reinfused. When the stem cells are reinfused, the immune system starts from scratch and if the trigger for autoimmune disease has been removed, the disease is cured. This is called 'Re-booting' of the immune system.

Allogeneic Bone Marrow Transplantation (BMT): This is a more definitive way of replacing the defective or diseased immune system with a new or healthy immune system from a donor.

What type of BMT is used?

This depends on the severity and type of autoimmune disease. The decision is taken by the rheumatologist, neurologist and BMT physician together.

Which diseases benefit most from BMT?

Autologous BMT shows most promising results for Scleroderma and Multiple Sclerosis. This should be done before permanent organ damage has occurred.

It can be useful for all autoimmune diseases, when the conventional treatments fail.

Why was this procedure not being carried out earlier in India?

  • Lack of awareness
  • Lack of collaboration between rheumatologists, neurologists and BMT Physicians
  • Lack of the right expertise and experience in carrying out BMT for this condition.
  • Lack of benefit when the patients are referred late.

This procedure is now available at our BMT centre.

When to see us for Autoimmune Disease

Refractory autoimmune disease, especially Scleroderma or MS, may benefit from BMT before permanent organ damage.

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