Autologous stem-cell transplantation in malignant multiple sclerosis: a case with a favorable long-term outcome.
Malignant multiple sclerosis (MS) is a rare but clinically important subtype of MS characterized by the rapid development of significant disability in the early stages of the disease process. These patients are refractory to conventional immunomodulatory agents and the mainstay of their treatment is plasmapheresis or immunosuppression with mitoxantrone, cyclophosphamide, cladribine or, lately, bone marrow transplantation. We report on the case of a 17-year old patient with malignant MS who was treated with high-dose chemotherapy plus anti-thymocyte globulin followed by autologous stem cell transplantation. This intervention resulted in an impressive and long-lasting clinical and radiological response. It is concluded that intensive immunosuppression followed by autologous stem cell transplantation is a viable therapeutic option in patients with malignant MS unresponsive to conventional forms of treatment.
Kimiskidis
Vk
V
Department of Neurology III, Aristotle University of Thessaloniki, George Papanikolaou Hospital, Thessaloniki, 570 10 Greece. kimiskid@med.auth.gr
Sakellari
I
I
Tsimourtou
V
V
Kapina
V
V
Papagiannopoulos
S
S
Kazis
D
D
Vlaikidis
N
N
Anagnostopoulos
A
A
Fassas
A
A
D000293:Adolescent; D000961:Antilymphocyte Serum / Q000627:therapeutic use; D003131:Combined Modality Therapy; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D008279:Magnetic Resonance Imaging; D008297:Male; D009103:Multiple Sclerosis / Q000188:drug therapy / Q000473:pathology / Q000628:therapy*; D020127:Recovery of Function; D033581:Stem Cell Transplantation; D014182:Transplantation, Autologous
D000961:Antilymphocyte Serum; D007166:Immunosuppressive Agents