title: Intense immunosuppression followed by autologous stem cell transplantation in severe multiple sclerosis.
abstract: Aggressive forms of multiple sclerosis (MS) represent a limited group of demyelinating diseases that rapidly progress to severe disability. Currently available therapies are poorly effective against these clinical entities. Recently, it has been demonstrated that intense immunosuppression followed by autologous haematopoietic stem cell transplantation (AHSCT) can affect the clinical course of individuals with severe MS and completely abrogate the inflammatory activity detected by MRI. We report the result of the Italian phase 2 GITMO study, a multicentre study in which 21 MS patients, who were rapidly deteriorating and not responding to the usual therapeutic strategies, were treated with this procedure. The clinical effect of the treatment is long lasting, with a striking abrogation of inflammation detected by MRI findings. These results support a role for intense immunosuppression followed by ASCT as treatment in rapidly evolving MS cases unresponsive to conventional therapies.
authors.affiliation: Department of Neurological Sciences Ophthalmology and Genetics, University of Genoa, Via De' Toni 5, I-16132, Genoa, Italy. ecapello@neurologia.unige.it
authors.forename: E
authors.initials: E
authors.lastname: Capello
authors.forename: R
authors.initials: R
authors.lastname: Saccardi
authors.forename: A
authors.initials: A
authors.lastname: Murialdo
authors.forename: F
authors.initials: F
authors.lastname: Gualandi
authors.forename: F
authors.initials: F
authors.lastname: Pagliai
authors.forename: A
authors.initials: A
authors.lastname: Bacigalupo
authors.forename: A
authors.initials: A
authors.lastname: Marmont
authors.forename: A
authors.initials: A
authors.lastname: Uccelli
authors.forename: M
authors.initials: M
authors.lastname: Inglese
authors.forename: P
authors.initials: P
authors.lastname: Bruzzi
authors.forename: M P
authors.initials: MP
authors.lastname: Sormani
authors.forename: E
authors.initials: E
authors.lastname: Cocco
authors.forename: G
authors.initials: G
authors.lastname: Meucci
authors.forename: L
authors.initials: L
authors.lastname: Massacesi
authors.forename: A
authors.initials: A
authors.lastname: Bertolotto
authors.forename: A
authors.initials: A
authors.lastname: Lugaresi
authors.forename: E
authors.initials: E
authors.lastname: Merelli
authors.forename: A
authors.initials: A
authors.lastname: Solari
authors.forename: M
authors.initials: M
authors.lastname: Filippi
authors.forename: G L
authors.initials: GL
authors.lastname: Mancardi
mesh_terms: D000328:Adult; D018380:Hematopoietic Stem Cell Transplantation / Q000379:methods*; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D007558:Italy; D008279:Magnetic Resonance Imaging; D009103:Multiple Sclerosis / Q000175:diagnosis / Q000276:immunology / Q000628:therapy*; D016879:Salvage Therapy; D012720:Severity of Illness Index; D014182:Transplantation, Autologous; D016896:Treatment Outcome
chemical_list: D007166:Immunosuppressive Agents