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From the Department of Neurology (Dr. Openshaw) and Division of Hematology and Bone Marrow Transplantation (Drs. Kashyap and Forman), City of Hope National Medical Center, Duarte, CA; the Departments of Neurology (Dr. Stuve) and Medical Oncology (Drs. Nash and McSweeney), Fred Hutchinson Cancer Research Center, University of Washington School of Medicine, Seattle; the Neuroimmunology Unit (Dr. Antel), Montreal Neurological Institute, McGill University, Montreal, Canada; and the Department of Neurology (Drs. Lund and Weiner), University of Southern California School of Medicine, Los Angeles.
Address correspondence and reprint requests to Dr. Harry Openshaw, Department of Neurology, City of Hope National Medical Center, 1500 East Duarte Road, Duarte, CA 91010; e-mail: hopenshaw{at}coh.org
Four of 10 patients who were enrolled on protocols of high-dose immunosuppression with peripheral blood stem cell rescue for MS experienced neurologic worsening while receiving recombinant human granulocyte colony-stimulating factor. There was improvement when methylprednisolone was given to three of the patients, but one patient died of respiratory failure. The mechanism of the neurologic worsening is uncertain.
Key words: MS—Granulocyte colony-stimulating factor—Stem cell transplantation—Immunosuppression.
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