SEARCH:   Advanced

Prepublished online as a Blood First Edition Paper on July 3, 2003; DOI 10.1182/blood-2003-03-0877. This Article Full Text Full Text (PDF) All Versions of this Article: 2003-03-0877v1 102/7/2373    most recent Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Rights and Permissions Citing Articles Citing Articles via HighWire Citing Articles via CrossRef Citing Articles via Google Scholar Google Scholar Articles by Burt, R. K. Articles by Burns, W. H. Search for Related Content PubMed PubMed Citation Articles by Burt, R. K. Articles by Burns, W. H. Related Collections Clinical Trials and Observations Social Bookmarking                   What's this?  Previous Article  |  Table of Contents  |  Next Article  Blood, 1 October 2003, Vol. 102, No. 7, pp. 2373-2378 CLINICAL OBSERVATIONS, INTERVENTIONS, AND THERAPEUTIC TRIALS 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 Richard K. Burt, Bruce A. Cohen, Eric Russell, Kenneth Spero, Akash Joshi, Yu Oyama, William J. Karpus, Kehuan Luo, Borko Jovanovic, Ann Traynor, Karyn Karlin, Dusan Stefoski, and William H. Burns From the Departments of Neurology, Medicine—Division of Immunotherapy, Radiology—Neuroradiology, Pathology, and Department of Preventive Medicine, Northwestern University Medical School, Chicago, IL; and Department of Neurology, Rush Saint Lukes Medical Center, Chicago, IL. There were 21 patients with rapidly progressive multiple sclerosis (MS) treated on a phase 1/2 study of intense immune suppressive therapy and autologous hematopoietic stem cell (HSC) support with no 1-year mortality. Following transplantation, one patient had a confirmed acute attack of MS. Neurologic progression defined by the expanded disability status scale (EDSS) did not increase in disability by 1.0 or more steps in any of 9 patients with a pretransplantation EDSS of 6.0 or less. In 8 of 12 patients with high pretransplantation disability scores (EDSS > 6.0), progressive neurologic disability as defined by at least a 1-point increase in the EDSS has occurred and was manifested as gradual neurologic deterioration. There were 2 patients with a pretransplantation EDSS of 7.0 and 8.0 who died from complications of progressive disease at 13 and 18 months following treatment. Our experience suggests that intense immune suppression using a total body irradiation (TBI)-based regimen and hematopoietic stem cell transplantation (HSCT) are not effective for patients with progressive disease and high pretransplantation disability scores. Further studies are necessary to determine the role of intense immune suppressive therapy and HSC support in ambulatory patients with less accumulated disability and more inflammatory disease activity. Specifically, more patients and longer follow-up would be required in patients with an EDSS of 6.0 or less before drawing conclusions on this subgroup. (Blood. 2003;102:2373-2378) CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this? This article has been cited by other articles: J Fagius, J Lundgren, and G Oberg Early highly aggressive MS successfully treated by hematopoietic stem cell transplantation Multiple Sclerosis, February 1, 2009; 15(2): 229 - 237. [Abstract] [PDF] A. L. Barnard, A. P. Chidgey, C. C. Bernard, and R. L. Boyd Androgen depletion increases the efficacy of bone marrow transplantation in ameliorating experimental autoimmune encephalomyelitis Blood, January 1, 2009; 113(1): 204 - 213. [Abstract] [Full Text] [PDF] R. K. Burt, Y. Loh, W. Pearce, N. Beohar, W. G. Barr, R. Craig, Y. Wen, J. A. Rapp, and J. Kessler Clinical Applications of Blood-Derived and Marrow-Derived Stem Cells for Nonmalignant Diseases JAMA, February 27, 2008; 299(8): 925 - 936. [Abstract] [Full Text] [PDF] Y. Loh, Y. Oyama, L. Statkute, K. Quigley, K. Yaung, E. Gonda, W. Barr, B. Jovanovic, R. Craig, D. Stefoski, et al. Development of a secondary autoimmune disorder after hematopoietic stem cell transplantation for autoimmune diseases: role of conditioning regimen used Blood, March 15, 2007; 109(6): 2643 - 2548. [Abstract] [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] M Daumer, L M Griffith, W Meister, R A Nash, and J S Wolinsky Survival, and time to an advanced disease state or progression, of untreated patients with moderately severe multiple sclerosis in a multicenter observational database: relevance for design of a clinical trial for high dose immunosuppressive therapy with autologous hematopoietic stem cell transplantation Multiple Sclerosis, April 1, 2006; 12(2): 174 - 179. [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] M. M. Herrmann, S. Gaertner, C. Stadelmann, J. van den Brandt, R. Boscke, W. Budach, H. M. Reichardt, and R. Weissert Tolerance induction by bone marrow transplantation in a multiple sclerosis model Blood, September 1, 2005; 106(5): 1875 - 1883. [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] 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] S. A. Rizvi and K. Bashir Other therapy options and future strategies for treating patients with multiple sclerosis Neurology, December 28, 2004; 63(12_suppl_6): S47 - S54. [Abstract] [Full Text] 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] M. S. Freedman and H. L. Atkins Suppressing immunity in advancing MS: Too much too late, or too late for much? Neurology, January 27, 2004; 62(2): 168 - 169. [Full Text] [PDF]

	Copyright © 2003 by American Society of Hematology         Online ISSN: 1528-0020