Scleroderma - Other Treatments

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Highlights	Diagnosis	Treatment for Lung Complications
Introduction	Treatment	Treatment for Gastrointestinal Problems
Symptoms	Medications	Treatment for Other Complications
Causes	Other Treatments	Resources
Risk Factors	Treatment for Raynaud's Phenomenon	References
Prognosis	Treatment for Skin Thickening

There are significant risks with stem cell transplants:

Transplantation does not work in all patients.
It cannot reverse all damage that may have been done during the disease process.
The treatment carries significant dangers. The mortality rate from the procedure itself is 10% in scleroderma patients, which is higher than in other patient groups who are given transplants.

Because the procedure has serious side effects, experts suggest that the best candidates would be those at high risk for complications from scleroderma. In general, such patients would have diffuse scleroderma whose first symptoms occurred within the previous three years and who have evidence of at least mild abnormalities in the heart, lungs, or kidney. In general, patients with advanced scleroderma would not be the best candidates, because their condition is usually stable. In such cases, the risks of the procedure would outweigh the risks from the disease.

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A Phase I trial of reduced-intensity stem cell transplant showed the procedure is safe and appears effective. A reduced-intensity stem cell transplant does not destroy the bone marrow, and therefore avoids many of the risks associated with the full-strength procedure. In this trial of 10 patients, survival rate was 90% (9 out of 10 people). Seven out of 10 people (70%) showed no progression of the disease during follow-up examination. Patients' skin improved significantly, and their heart, lung, and kidney functions remained stable during the 12-month study.

Intermittent pneumatic compression (IPC) pump therapy. During this therapy, a band wrapped around the arm is inflated and deflated. This helps stimulate blood flow. Experts are studying the use of IPC pump therapy for patients with ulcers on their arms. Medications usually do not work for such ulcers, and amputation is usually the only option for such patients. However, a small pilot study has shown that IPC pump therapy for an average of 5 hours per day healed 96% of ulcers.

Intravenous immunoglobulin (IVIg).Animal studies have found that administration of IVIg, an agent that modifies the immune system, may reduce the severity of scleroderma and other autoimmune diseases. Early studies in patients with scleroderma found it can improve skin fibrosis.