High-dose immunosuppressive therapy with autologous hematopoietic stem cell transplantation as a treatment option in multiple sclerosis
| Autor: | Vladimir Y. Melnichenko, Igor A. Lisukov, Andrei A. Novik, Yury L. Shevchenko, Sergei V. Shamanski, Oleg A. Rykavicin, Boris V. Afanasiev, Denis A. Fedorenko, Gary I. Gorodokin, Aleksey N. Kuznetsov, Alexander D. Kulagin, Tatyana Ionova, Roman Ivanov, Vladimir A. Kozlov |
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| Rok vydání: | 2008 |
| Předmět: |
Adult
Male Cancer Research medicine.medical_specialty Multiple Sclerosis Adolescent medicine.medical_treatment Disease Hematopoietic stem cell transplantation Transplantation Autologous Disease-Free Survival Russia Internal medicine Genetics medicine Humans Molecular Biology Expanded Disability Status Scale medicine.diagnostic_test business.industry Multiple sclerosis Hematopoietic Stem Cell Transplantation Treatment options Magnetic resonance imaging Cell Biology Hematology Objective Improvement Middle Aged medicine.disease Combined Modality Therapy Surgery Transplantation Treatment Outcome Female business Immunosuppressive Agents Follow-Up Studies |
| Zdroj: | Experimental Hematology. 36:922-928 |
| ISSN: | 0301-472X |
| DOI: | 10.1016/j.exphem.2008.03.001 |
| Popis: | High-dose immunosuppressive therapy (HDIT) with autologous hematopoietic stem cell transplantation (auto-HSCT) is a new and promising approach to the treatment of multiple sclerosis (MS) patients because currently there are no effective treatment methods for this disease. In this article, we present results of a prospective clinical study of efficacy of HDIT + auto-HSCT in MS patients. The following treatment strategies were employed in the study: "early," "conventional," and "salvage/late" transplantation. Fifty patients with various types of MS were included in this study. No toxic deaths were reported among 50 MS patients; transplantation procedure was well-tolerated by the patients. The efficacy analysis was performed in 45 patients. Twenty-eight patients achieved an objective improvement of neurological symptoms, defined as at least 0.5-point decrease in the Expanded Disability Status Scale (EDSS) score as compared to the baseline and confirmed during 6 months, and 17 patients had disease stabilization (steady EDSS level as compared to the baseline and confirmed during 6 months). The progression-free survival at 6 years after HDIT + auto-HSCT was 72%. Magnetic resonance imaging data were available in 37 patients before transplantation showing disease activity in 43.3%. No active, new, or enlarging lesions were registered in patients without disease progression. In conclusion, HDIT + auto-HSCT suggests positive results in management of patients with different types of MS. Identification of treatment strategies based on the level of disability, namely "early," "conventional," and "salvage/late" transplantation, appears to be feasible to improve treatment outcomes. |
| Databáze: | OpenAIRE |
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