[Clinical outcome 6 years after autologous hematopoietic stem cell transplantation in multiple sclerosis].
BACKGROUND
Autologous hematopoietic stem cell transplantation (AHSCT) remains as an experimental treatment for severe forms of multiple sclerosis (MS). We describe the clinical outcome of 14 patients included in a protocol of AHSCT after a median follow-up period of 6 years.


METHODS
14 patients (5 relapsing-remitting and 9 secondary progressive) with a median number of relapses in the year before of 3 (1-7), Expanded Disability Status Scale (EDSS) of 6 (4.5-6.5) and decile of the multiple Sclerosis Severity Store (MSSS) 9 (7-10) were included. The procedure included carmustine, cyclophosphamide, antithymocyte globulin and T-cell depletion by CD34+ selection.


RESULTS
The 4.5-year progression-free survival was 71%. The 6 year actuarial probability of progression-free survival was 62.5% and the disease activity-free survival of 7.1%. The median EDSS was 6 (4-8.5) and the MSSS 8 (5-10). Only 2 patients presented enhanced T1 lesions. No long-term complications related to the procedure were observed.


CONCLUSIONS
AHSCT cannot be deemed a curative treatment but may cause prolonged stabilisation or change the aggressive course of the disease.
Saiz
A
A
Servicio de Neurología, Hematología Hospital Clínic, Institut d'Investigació Biomèdica August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Barcelona. asaiz@clinic.ub.es
Blanco
Y
Y
Berenguer
J
J
Gómez-Choco
M
M
Carreras
E
E
Arbizu
T
T
Graus
F
F
D018450:Disease Progression; D018572:Disease-Free Survival; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D009103:Multiple Sclerosis / Q000473:pathology / Q000503:physiopathology / Q000628:therapy*; D014182:Transplantation, Autologous; D016896:Treatment Outcome