Scleroderma

How does HSCT work?

• All immune cells in the body originate from a common progenitor, known as a hematopoietic stem cell (HSC) found in the bone marrow. As the HSC divides, it gives rise to a wide diversity of immune cell repertoire that all serve specific immune functions. Many of these immune cells, known as lymphocytes, are capable of recognizing and defending against foreign pathogens that enter the body.
• For an, as yet, unknown reason, some of the lymphocyte immune cells develop a corrupted memory in which they become self-intolerant and attack & damage different cells and tissues of the body. In the same manner as normal cells divide, so does the mutant auto-toxic cell clone, giving rise to a large population of autoreactive cells that mediate damage of different normal structures.
• Progressive systemic sclerosis results from autoimmune responses to several intracellular antigens such as fibrillarin, centromeric proteins and RNA polymerase II. This is the fundamental mechanism that underlies autoimmune disease and using chemotherapy to eliminate these self-intolerant auto-toxic lymphocytes is the key to also halting the underlying autoimmune disease. The immune cells eliminated from the body are eventually replaced with new immune cells created in the bone marrow, which do not contain toxic corrupted cells, thereby halting the underlying disease activity.

Eligibility / Inclusion Criteria

• Patients with a confirmed positive diagnosis of the following rheumatic disorder are eligible for HSCT treatment: Diffuse type of Scleroderma / Systemic Sclerosis
• Patients must be free of contraindicating health factors as determined by the clinic HSCT physician, and be deemed suitably healthy to safely tolerate the treatment.
• Patients may be considered for treatment based upon individual health status between the ages of 18 and 65 years.
• Patient has to be able to travel to and remain in Monterrey, Mexico during a 28-day period, accompanied by a caregiver.
• If a medical condition appears in the preliminary evaluations performed by our specialists that impedes the patient from receiving the transplant, the patient will be refunded. The only charges that will apply will be the ones consumed up to that point, such as, transportation, partial lodging and the evaluations performed.
• Treatment must be fully paid two months prior to schedule treatment.

Exclusion criteria

• End stage organ failure
• Severe PAH (pulmonary arterial hypertension) with a mean PASP greater than >50mmHg
• Extensive pretreatment with cyclophosphamide (CYC) greater than >5g/m2 IV or more than 6 months of continuous use of cyclophosphamide
• LVEF (left ventricular ejection fraction) as determined by transthoracic echocardiogram less than <45%
• Symptomatic cardiac disease
• Pulmonary function test with DLCO of less than 40%, FVC less than 45% or predicted total lung capacity of less 45%
• HIV positive, hepatitis B surface antigen positive, hepatitis C positive serology
• Renal insufficiency (creatinine >1.7 mg/dl) or creatinine clearance less than 40mL/min