Woman with 3 autoimmune diseases achieves remarkable recovery after cell therapy

A 47-year-old woman who lived with three life-threatening autoimmune diseases for more than a decade has returned to near-normal life after a cell therapy reset her immune system.

The woman, whose identity was not disclosed, had undergone nine different treatments without lasting effect before receiving the therapy last year at University Hospital Erlangen in Germany. At the time, she required daily blood transfusions and permanent blood thinning medication to control her illnesses.

Within weeks of the cell therapy, doctors observed that all three diseases responded, marking a world first and a striking improvement in her condition. For the past 14 months, she has been in treatment-free remission and largely able to resume normal activities.

Prof. Fabian Müller, who led the medical team, described the speed and depth of her response as “remarkable” and said the therapy had “significantly improved her quality of life.” He noted that clinical trials were needed to assess the therapy’s durability and potential effectiveness for other autoimmune diseases.

The woman suffered from a rare, life-threatening blood disorder, autoimmune haemolytic anaemia (AIHA), in which rogue immune defenses destroy red blood cells. During flare-ups, patients require immunosuppressant drugs and regular blood transfusions. For this patient, standard treatments had ceased to work. “The patient had no treatment options left and would not have left the ward as she needed daily transfusions,” Müller said.

In addition to AIHA, the woman had two other autoimmune diseases: immune thrombocytopenia (ITP), driven by immune cells destroying platelets and raising bleeding risk; and antiphospholipid syndrome (APS), which has an opposing effect and increases the risk of harmful blood clots. All three diseases stemmed from wayward B-cells that produce infection-fighting antibodies.

With no remaining options, doctors offered a treatment known as CAR (chimeric antigen receptor) T-cell therapy, which has proven transformative for certain cancers. The team extracted the woman’s white blood cells, isolated her T-cells, engineered them to recognize a protein called CD19 found on B-cells, and re-infused them into the patient.

The therapy swiftly destroyed the rogue B-cells. The woman received her last blood transfusion one week after treatment and was strong enough for everyday activities two weeks later. Her immune system appeared to stop attacking her red blood cells, and her other autoimmune conditions improved. When her B-cells rebounded months later, they appeared healthy, suggesting the therapy had reset her immune system. Details were published in the journal Med.

The woman still has a low white blood cell count and slightly elevated liver enzymes, but researchers believe these are due to years of previous treatments rather than the CAR-T therapy.

Prof. Ben Parker, a consultant rheumatologist at the Kellgren Centre for Rheumatology at Manchester University NHS Foundation Trust, said it was encouraging that all the patient’s conditions seemed to respond. “The prolonged response off normal therapy suggests there has been an immune reset,” he said, though how long it would last remained unclear.

Parker, who is leading CAR-T trials on lupus and related autoimmune conditions in Manchester, said, “There are many active trials currently recruiting across autoimmune conditions, including lupus, myositis, MS, systemic sclerosis, vasculitis, and some have already reported early results. Case reports don’t prove a treatment works for wider use, hence the need for trials.”