[Clinical course of multiple sclerosis in patients treated with cytostatic drugs for cancer].
BACKGROUND
The risk of side effects secondary to global and non-specific immune suppression has limited the systematic application of immunosuppressive therapy in multiple sclerosis (MS). However, when a patient with MS develops a cancer, cytostatic drugs as treatment for the neoplastic process may induce improvement not only of the cancer but also of MS.


METHODS
We present a series of four women with clinically defined MS and subjected to cytostatic therapy (cisplatin, 5-fluorouracil, leukovorin, adriamycin, tamoxifen and anastrozole) after the development of cancer: two presented breast cancer, one colon cancer, and the fourth parotid gland malignancy. Their clinical and neuroimaging course is described, following chemotherapy for the malignant disease. None of the patients have suffered further MS outbreaks. The four women have improved and remain clinically stable after neoplastic treatment. Magnetic resonance imaging showed persistence of the same lesion burden in three patients, and reduction in the other. At the present one patient receives weekly intramuscular interferon-beta 1a, whereas the other did not received any treatment.


CONCLUSIONS
Probably there are no specific cytostatics for MS. Immunosuppressive therapy could be a therapeutic option among patients with an aggressive clinical course.
Santos-García
D
D
Servicio de Neurología, Complexo Hospitalario Universitario de Santiago de Compostela, A Coruña, España. diegosangar@yahoo.es
Prieto
J M
JM
Lema
M
M
D000230:Adenocarcinoma / Q000150:complications / Q000188:drug therapy / Q000601:surgery; D000328:Adult; D000077384:Anastrozole; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D001921:Brain / Q000473:pathology*; D001943:Breast Neoplasms / Q000150:complications / Q000188:drug therapy / Q000532:radiotherapy / Q000601:surgery; D018267:Carcinoma, Acinar Cell / Q000150:complications / Q000188:drug therapy; D018270:Carcinoma, Ductal, Breast / Q000150:complications / Q000188:drug therapy / Q000532:radiotherapy / Q000601:surgery; D002945:Cisplatin / Q000008:administration & dosage; D003110:Colonic Neoplasms / Q000150:complications / Q000188:drug therapy / Q000601:surgery; D003131:Combined Modality Therapy; D003520:Cyclophosphamide / Q000008:administration & dosage; D054697:Cytostatic Agents / Q000627:therapeutic use*; D004317:Doxorubicin / Q000008:administration & dosage; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects / Q000627:therapeutic use; D002955:Leucovorin / Q000008:administration & dosage; D008279:Magnetic Resonance Imaging; D008775:Methylprednisolone / Q000009:adverse effects / Q000627:therapeutic use; D020528:Multiple Sclerosis, Chronic Progressive / Q000150:complications / Q000473:pathology*; D020529:Multiple Sclerosis, Relapsing-Remitting / Q000150:complications / Q000188:drug therapy / Q000473:pathology*; D009369:Neoplasms / Q000150:complications / Q000188:drug therapy*; D009570:Nitriles / Q000008:administration & dosage; D010307:Parotid Neoplasms / Q000150:complications / Q000188:drug therapy / Q000532:radiotherapy / Q000601:surgery; D013629:Tamoxifen / Q000008:administration & dosage; D014230:Triazoles / Q000008:administration & dosage
D000970:Antineoplastic Agents; D054697:Cytostatic Agents; D007166:Immunosuppressive Agents; D009570:Nitriles; D014230:Triazoles; D013629:Tamoxifen; D000077384:Anastrozole; D004317:Doxorubicin; D003520:Cyclophosphamide; D002945:Cisplatin; D002955:Leucovorin; D005472:Fluorouracil; D008775:Methylprednisolone