Autologous haematopoietic stem cell transplantation in CIDP: Taking a hammer to the walnut?

Chronic inflammatory demyelinating neuropathy (CIDP) remains a difficult disorder to treat, particularly when patients fail to respond to one of the first line therapies.  In addition, complications relating steroid and impressive treatments remain high    and disability for this disorder is invariably a difficult management problem.  In the June issue of JNNP, the utility of autologous stem cell transplantation was investigated.  In a small study Press and colleagues report on clinical improvement in CIDP patients 2-6 months after therapy.  However, a substantial proportion relapsed requiring further treatment and the complications were potentially serious, including pancreatitis and hemorrhagic cystitis.

The question of therapeutic utility remains, particularly selecting the appropriate patient.  Further studies are clearly needed, but none-the-less this is a must read article for the neuromuscular physicians.


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