Stem cell transplantation for Crohnʹs disease

There is much interest in the possibility that haematopoietic stem cell transplantation might benefit patients with inflammatory bowel disease, with an emphasis on Crohnʹs disease. Case reports of patients with Crohnʹs disease undergoing stem cell transplantation for other reasons, or specifically for Crohnʹs disease, support the view that major improvements can be achieved, with even the possibility of a cure in a small number of, but certainly not all, cases. The development of Crohnʹs disease in a previously normal patient receiving an allogeneic transplant from an individual with the NOD2 mutation illustrates the importance of the genotype of the immune system. Population of the lamina propria by myofibroblasts with the donorʹs phenotype shows that non-immune mechanisms make also play a part. A clinical trial to determine the value of stem cell transplantation in Crohnʹs disease has been set up under the supervision of the European Group for Blood and Marrow Transplantation.