Autologous haematopoietic stem cell transplantation for aggressive multiple sclerosis: the Swedish experience.
J Neurol Neurosurg Psychiatry
; 85(10): 1116-21, 2014 Oct.
Article
en En
| MEDLINE
| ID: mdl-24554104
ABSTRACT
BACKGROUND:
Autologous haematopoietic stem cell transplantation (HSCT) is a viable option for treatment of aggressive multiple sclerosis (MS). No randomised controlled trial has been performed, and thus, experiences from systematic and sustained follow-up of treated patients constitute important information about safety and efficacy. In this observational study, we describe the characteristics and outcome of the Swedish patients treated with HSCT for MS.METHODS:
Neurologists from the major hospitals in Sweden filled out a follow-up form with prospectively collected data. Fifty-two patients were identified in total; 48 were included in the study and evaluated for safety and side effects; 41 patients had at least 1 year of follow-up and were further analysed for clinical and radiological outcome. In this cohort, 34 patients (83%) had relapsing-remitting MS, and mean follow-up time was 47 months.RESULTS:
At 5 years, relapse-free survival was 87%; MRI event-free survival 85%; expanded disability status scale (EDSS) score progression-free survival 77%; and disease-free survival (no relapses, no new MRI lesions and no EDSS progression) 68%. Presence of gadolinium-enhancing lesions prior to HSCT was associated with a favourable outcome (disease-free survival 79% vs 46%, p=0.028). There was no mortality. The most common long-term side effects were herpes zoster reactivation (15%) and thyroid disease (8.4%).CONCLUSIONS:
HSCT is a very effective treatment of inflammatory active MS and can be performed with a high degree of safety at experienced centres.Palabras clave
Texto completo:
1
Bases de datos:
MEDLINE
Asunto principal:
Trasplante Autólogo
/
Encéfalo
/
Trasplante de Células Madre Hematopoyéticas
/
Esclerosis Múltiple
Tipo de estudio:
Clinical_trials
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Límite:
Adolescent
/
Adult
/
Child
/
Female
/
Humans
/
Male
/
Middle aged
País/Región como asunto:
Europa
Idioma:
En
Revista:
J Neurol Neurosurg Psychiatry
Año:
2014
Tipo del documento:
Article
País de afiliación:
Suecia