| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
|
|
|
|||||||
|
|||||||||
From the Department of Neurological Sciences and Vision (Drs. Mancardi and Murialdo), University of Genova; II Division of Hematology and Stem Cell Transplantation Centre (Drs. Gualandi and Marmont), San Martino’s Hospital; Unit of Clinical Epidemiology and Trials (Dr. Sormani), National Cancer Institute; Department of Radiology (Dr. Sardanelli), Biomedical Institute, Genova; Bone Marrow Transplantation Unit (Drs. Saccardi and Pagliai), Careggi Hospital; Department of Neurological and Psychiatric Sciences (Dr. Massacesi), University of Firenze; Neuroimaging Research Unit (Drs. Filippi and Inglese), Department of Neuroscience, Scientific Institute, Ospedale San Raffaele, Milan; Department of Neuroscience (Dr. Marrosu), University of Cagliari; Department of Neuroscience (Dr. Meucci), University of Pisa; and Department of Oncology and Neuroscience (Dr. Lugaresi), University "Gabriele d’Annunzio," Chieti, Italy.
Address correspondence and reprint requests to Dr. G.L. Mancardi, Department of Neurological Sciences and Vision, University of Genova, via de Toni 5, 16132 Genova, Italy; e-mail: neurolab{at}cisi.unige.it
BACKGROUND: Autologous hematopoietic stem cell transplantation (ASCT) has been recently utilized with encouraging results in patients with poorly controlled MS.
OBJECTIVE: To determine in severe cases of MS the effect of ASCT on gadolinium (Gd)-enhanced MRI and to obtain information on clinical course and safety.
METHODS: In a cooperative study, 10 patients with rapidly evolving secondary progressive MS were transplanted, after BEAM conditioning regimen (carmustine, etoposide, cytosine-arabinoside, and melphalan), with unmanipulated autologous peripheral blood SC mobilized with high-dose cyclophosphamide (CY; 4 g/m2) and granulocyte-colony-stimulating factor. Triple-dose Gd-enhanced scans were performed monthly for a pretreatment period of 3 months and compared with serial monthly Gd-enhanced MRI for the following 6 months and then once every 3 months.
RESULTS: The median follow-up is now 15 months (range 4 to 30 months). The number of Gd-enhancing lesions decreased immediately after mobilization with CY and finally dropped to zero in all cases after the conditioning regimen. The number of new T2-weighted positive lesions paralleled data obtained for Gd-enhanced MRI. Clinically, patients improved slightly or remained stable.
CONCLUSION: These results demonstrate that the therapeutic sequence CY–BEAM–ASCT has the capacity to completely suppress MR-enhancing activity, an effect that is sustained with time. The final impact of this procedure on disease course remains to be established.
This article has been cited by other articles:
|
|
 |
|
  C. Krishnan, A. I. Kaplin, R. A. Brodsky, D. B. Drachman, R. J. Jones, D. L. Pham, N. D. Richert, C. A. Pardo, D. M. Yousem, E. Hammond, et al. Reduction of Disease Activity and Disability With High-Dose Cyclophosphamide in Patients With Aggressive Multiple Sclerosis Arch Neurol, August 1, 2008; 65(8): 1044 - 1051. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M.A. Rocca, T. Mondria, P. Valsasina, M.P. Sormani, Z.H. Flach, P.A. Te Boekhorst, G. Comi, R.Q. Hintzen, and M. Filippi A Three-Year Study of Brain Atrophy after Autologous Hematopoietic Stem Cell Transplantation in Rapidly Evolving Secondary Progressive Multiple Sclerosis AJNR Am. J. Neuroradiol., October 1, 2007; 28(9): 1659 - 1661. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 L. Roccatagliata, M. Rocca, P. Valsasina, L. Bonzano, M. Sormani, R. Saccardi, G. Mancardi, M. Filippi, and for the Italian GITMO-NEURO Intergroup on Autologo The long-term effect of AHSCT on MRI measures of MS evolution: a five-year follow-up study Multiple Sclerosis, September 1, 2007; 13(8): 1068 - 1070. [Abstract] [PDF]
|
|
|
|
|
|
E. Portaccio, M.P. Amato, G. Siracusa, F. Pagliai, S. Sorbi, S. Guidi, A. Bosi, and R. Saccardi Autologous hematopoietic stem cell transplantation for very active relapsing-remitting multiple sclerosis: report of two cases Multiple Sclerosis, June 1, 2007; 13(5): 676 - 678. [Abstract] [PDF]
|
|
|
|
 |
|
 R. Martin Is haematopoietic stem cell transplantation a treatment option for severe MS or not? Brain, May 1, 2007; 130(5): 1181 - 1182. [Full Text] [PDF]
|
|
|
|
|
|
R Saccardi, T Kozak, C Bocelli-Tyndall, A Fassas, A Kazis, E Havrdova, E Carreras, A Saiz, B Lowenberg, P A. te Boekhorst, et al. Autologous stem cell transplantation for progressive multiple sclerosis: Update of the European Group for Blood and Marrow Transplantation autoimmune diseases working party database Multiple Sclerosis, November 1, 2006; 12(6): 814 - 823. [Abstract] [PDF]
|
|
|
|
 |
|
 J P A Samijn, P A W te Boekhorst, T Mondria, P A van Doorn, H Z Flach, F G A van der Meche, J Cornelissen, W C Hop, B Lowenberg, and R Q Hintzen Intense T cell depletion followed by autologous bone marrow transplantation for severe multiple sclerosis J. Neurol. Neurosurg. Psychiatry, January 1, 2006; 77(1): 46 - 50. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
G. L. Mancardi, A. Murialdo, P. Rossi, F. Gualandi, G. Martino, A. Marmont, F. Ciceri, A. Schenone, R. C. Parodi, E. Capello, et al. Autologous stem cell transplantation as rescue therapy in malignant forms of multiple sclerosis Multiple Sclerosis, June 1, 2005; 11(3): 367 - 371. [Abstract] [PDF]
|
|
|
|
|
|
R. K. Burt, B. Cohen, J. Rose, F. Petersen, Y. Oyama, D. Stefoski, G. Katsamakis, E. Carrier, T. Kozak, P. A. Muraro, et al. Hematopoietic Stem Cell Transplantation for Multiple Sclerosis Arch Neurol, June 1, 2005; 62(6): 860 - 864. [Full Text] [PDF]
|
|
|
|
|
|
M. S. Freedman, E. J. Thompson, F. Deisenhammer, G. Giovannoni, G. Grimsley, G. Keir, S. Ohman, M. K. Racke, M. Sharief, C. J. M. Sindic, et al. Recommended Standard of Cerebrospinal Fluid Analysis in the Diagnosis of Multiple Sclerosis: A Consensus Statement Arch Neurol, June 1, 2005; 62(6): 865 - 870. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 R. Saccardi, G. L. Mancardi, A. Solari, A. Bosi, P. Bruzzi, P. Di Bartolomeo, A. Donelli, M. Filippi, A. Guerrasio, F. Gualandi, et al. Autologous HSCT for severe progressive multiple sclerosis in a multicenter trial: impact on disease activity and quality of life Blood, March 15, 2005; 105(6): 2601 - 2607. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 P. A. Muraro, D. C. Douek, A. Packer, K. Chung, F. J. Guenaga, R. Cassiani-Ingoni, C. Campbell, S. Memon, J. W. Nagle, F. T. Hakim, et al. Thymic output generates a new and diverse TCR repertoire after autologous stem cell transplantation in multiple sclerosis patients J. Exp. Med., March 7, 2005; 201(5): 805 - 816. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
K. M Healey, S. Z Pavletic, J. Al-Omaishi, M P. Leuschen, S. J Pirruccello, M. L Filipi, C. Enke, M. M. Ursick, F. Hahn, J D Bowen, et al. Discordant functional and inflammatory parameters in multiple sclerosis patients after autologous haematopoietic stem cell transplantation Multiple Sclerosis, June 1, 2004; 10(3): 284 - 289. [Abstract] [PDF]
|
|
|
|
|
|
L. Kappos Effect of drugs in secondary disease progression in patients with multiple sclerosis Multiple Sclerosis, June 1, 2004; 10(1_suppl): S46 - S55. [Abstract] [PDF]
|
|
|
|
|
|
L. Kappos Effect of drugs in secondary disease progression in patients with multiple sclerosis Multiple Sclerosis, May 1, 2004; 10(3_suppl): S46 - S55. [Abstract] [PDF]
|
|
|
|
|
|
M Inglese, G L Mancardi, E Pagani, M A Rocca, A Murialdo, R Saccardi, G Comi, and M Filippi Brain tissue loss occurs after suppression of enhancement in patients with multiple sclerosis treated with autologous haematopoietic stem cell transplantation J. Neurol. Neurosurg. Psychiatry, April 1, 2004; 75(4): 643 - 644. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. Saiz, Y. Blanco, E. Carreras, J. Berenguer, M. Rovira, T. Pujol, P. Marin, T. Arbizu, and F. Graus Clinical and MRI outcome after autologous hematopoietic stem cell transplantation in MS Neurology, January 27, 2004; 62(2): 282 - 284. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. A. Nash, J. D. Bowen, P. A. McSweeney, S. Z. Pavletic, K. R. Maravilla, M.-s. Park, J. Storek, K. M. Sullivan, J. Al-Omaishi, J. R. Corboy, et al. High-dose immunosuppressive therapy and autologous peripheral blood stem cell transplantation for severe multiple sclerosis Blood, October 1, 2003; 102(7): 2364 - 2372. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. K. Burt, B. A. Cohen, E. Russell, K. Spero, A. Joshi, Y. Oyama, W. J. Karpus, K. Luo, B. Jovanovic, A. Traynor, et al. Hematopoietic stem cell transplantation for progressive multiple sclerosis: failure of a total body irradiation-based conditioning regimen to prevent disease progression in patients with high disability scores Blood, October 1, 2003; 102(7): 2373 - 2378. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. C. Marty, F. Alliot, J. Rutin, R. Fritz, D. Trisler, and B. Pessac The myelin basic protein gene is expressed in differentiated blood cell lineages and in hemopoietic progenitors PNAS, June 25, 2002; 99(13): 8856 - 8861. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
H L Weiner and J A Cohen Treatment of multiple sclerosis with cyclophosphamide: critical review of clinical and immunologic effects Multiple Sclerosis, April 1, 2002; 8(2): 142 - 154. [Abstract] [PDF]
|
|
|
|
|
|
R. K. Burt, S. Slavin, W. H. Burns, and A. M. Marmont Induction of tolerance in autoimmune diseases by hematopoietic stem cell transplantation: getting closer to a cure? Blood, February 1, 2002; 99(3): 768 - 784. [Abstract] [Full Text] [PDF]
|
|
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
