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Early highly aggressive MS successfully treated by hematopoietic stem cell transplantation

Fagius, J.; Lundgren, Johan LU and Oberg, G. (2009) 23rd Congress of the European-Committee-for-Treatment-and-Research-in-Multiple-Sclerosis/12th Annual Conference of Rehabilitation in MS In Multiple Sclerosis 15(2). p.229-237
Abstract
Background During the last 15 years, high-dose chemotherapy with autologous hematopoietic stem cell transplantation (HSCT) has globally been performed for severe multiple sclerosis (MS). Most patients have been in progressive phase with long disease duration. As a rule, treatment effect has been minor or moderate. Patients Since 2004, we have performed HSCT in nine young patients with "malignant" relapsing remitting MS. Criteria for treatment were short duration of disease; very frequent, severe relapses; recent improvement periods indicating potential for recovery after strong immunosuppression. Findings Median age at treatment was 27 (range 9-34) years, MS duration 26 (4-100) months, and annualized relapse rate 10 (4-12). Median... (More)
Background During the last 15 years, high-dose chemotherapy with autologous hematopoietic stem cell transplantation (HSCT) has globally been performed for severe multiple sclerosis (MS). Most patients have been in progressive phase with long disease duration. As a rule, treatment effect has been minor or moderate. Patients Since 2004, we have performed HSCT in nine young patients with "malignant" relapsing remitting MS. Criteria for treatment were short duration of disease; very frequent, severe relapses; recent improvement periods indicating potential for recovery after strong immunosuppression. Findings Median age at treatment was 27 (range 9-34) years, MS duration 26 (4-100) months, and annualized relapse rate 10 (4-12). Median Disability Status Scale (extended disability status scale, EDSS) at HSCT was 7.0 (3.5-8.0). Median follow-up time April 2008 is 29 (23-47) months. Median EDSS improvement is 3.5 (1.0-7.0), clearly surpassing most previous reports. One patient relapsed mildly with rapid recovery 7 months after HSCT. All patients are otherwise stable, median EDSS being 2.0 (0-6.0). Before HSCT, 61 relapses occurred in 82 patient months; during follow-up, one relapse in 289 patient months. Conclusion This small series of patients with "malignant" relapsing-remitting MS suggests HSCT to be an effective treatment option for this relatively rare disease course. It further suggests that future criteria for HSCT in MS should be close to the present ones. Multiple Sclerosis 2009; 15: 229-237. http://msj.sagepub.com (Less)
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author
organization
publishing date
type
Chapter in Book/Report/Conference proceeding
publication status
published
subject
keywords
malignant MS, transplantation, hematopoietic stem cell, HSCT, early MS, high-dose chemotherapy, relapsing-remitting MS
in
Multiple Sclerosis
volume
15
issue
2
pages
229 - 237
publisher
SAGE Publications Inc.
conference name
23rd Congress of the European-Committee-for-Treatment-and-Research-in-Multiple-Sclerosis/12th Annual Conference of Rehabilitation in MS
external identifiers
  • wos:000262954500010
  • scopus:59349089705
ISSN
1352-4585
1477-0970
DOI
10.1177/1352458508096875
language
English
LU publication?
yes
id
c2f185fe-2619-4e59-a026-bf7bf0e9153d (old id 1311364)
date added to LUP
2009-03-23 15:41:54
date last changed
2017-10-16 09:43:42
@inproceedings{c2f185fe-2619-4e59-a026-bf7bf0e9153d,
  abstract     = {Background During the last 15 years, high-dose chemotherapy with autologous hematopoietic stem cell transplantation (HSCT) has globally been performed for severe multiple sclerosis (MS). Most patients have been in progressive phase with long disease duration. As a rule, treatment effect has been minor or moderate. Patients Since 2004, we have performed HSCT in nine young patients with "malignant" relapsing remitting MS. Criteria for treatment were short duration of disease; very frequent, severe relapses; recent improvement periods indicating potential for recovery after strong immunosuppression. Findings Median age at treatment was 27 (range 9-34) years, MS duration 26 (4-100) months, and annualized relapse rate 10 (4-12). Median Disability Status Scale (extended disability status scale, EDSS) at HSCT was 7.0 (3.5-8.0). Median follow-up time April 2008 is 29 (23-47) months. Median EDSS improvement is 3.5 (1.0-7.0), clearly surpassing most previous reports. One patient relapsed mildly with rapid recovery 7 months after HSCT. All patients are otherwise stable, median EDSS being 2.0 (0-6.0). Before HSCT, 61 relapses occurred in 82 patient months; during follow-up, one relapse in 289 patient months. Conclusion This small series of patients with "malignant" relapsing-remitting MS suggests HSCT to be an effective treatment option for this relatively rare disease course. It further suggests that future criteria for HSCT in MS should be close to the present ones. Multiple Sclerosis 2009; 15: 229-237. http://msj.sagepub.com},
  author       = {Fagius, J. and Lundgren, Johan and Oberg, G.},
  booktitle    = {Multiple Sclerosis},
  issn         = {1352-4585},
  keyword      = {malignant MS,transplantation,hematopoietic stem cell,HSCT,early MS,high-dose chemotherapy,relapsing-remitting MS},
  language     = {eng},
  number       = {2},
  pages        = {229--237},
  publisher    = {SAGE Publications Inc.},
  title        = {Early highly aggressive MS successfully treated by hematopoietic stem cell transplantation},
  url          = {http://dx.doi.org/10.1177/1352458508096875},
  volume       = {15},
  year         = {2009},
}