Stem Cell Transplantation for Treatment of Crohn's Fistulae

Up to 20% of patients with Crohn's disease (CD) may have perianal fistula disease, which is frequently associated with perianal collections [1]. Classically, surgery has played an important role, by the placement of drains or setons creation of ostomies, and in severe cases, even proctectomy [2]. However, in recent years, medical treatment with or without the temporary placement of drains, has taken a leading role. Immunosuppressants such as azathioprine, 6-mercaptopurine, methotrexate, and cyclosporine have proven beneficial in many patients. In more complicated cases where these drugs are ineffective, biological treatments based on monoclonal antibodies have been shown to have some success for the induction and maintenance of remission of perianal fistula disease and associated proctitis [3]. Still, the percentage of patients who do not respond or do so only partially remain significant. Furthermore, the existence of serious complications associated with treatment should not be overlooked [4].