title: Brazilian experience with two conditioning regimens in patients with multiple sclerosis: BEAM/horse ATG and CY/rabbit ATG.
abstract: Studies have shown that autologous hematopoietic SCT (HSCT) can be used as an intensive immunosuppressive therapy to treat refractory patients and to prevent the progression of multiple sclerosis (MS). This is a prospective multicentric Brazilian MS trial comparing two conditioning regimens: BEAM/horse ATG and CY/rabbit ATG. Most (80.4%) of the 41 subjects in the study had the secondary progressive MS subtype and the mean age was 42 years. The baseline EDSS score in 58.5% of the subjects was 6.5 and 78% had a score of 6.0 or higher, respectively. The complication rate during the intra-transplantation period was 56% for all patients: 71.4% of the patients in the BEAM/hATG group and 40% in the CY/rATG group (P=0.04). Three subjects (7.5%) died of cardiac toxicity, sepsis and alveolar hemorrhage, all of them in the BEAM/ATG group. EFS was 58.54% for all patients: 47% in the BEAM/hATG group and 70% in the CY/rATG group (P=0.288). In conclusion, the CY/rATG regimen seems to be associated with similar outcome results, but presented less toxicity when compared with the BEAM/hATG regimen. Long-term follow-up would be required to fully assess the differences in therapeutic effectiveness between the two regimens.
authors: Hospital Israelita Albert Einstein, São Paulo, Brazil. hamer@einstein.br
authors: N
authors: N
authors: Hamerschlak
authors: M
authors: M
authors: Rodrigues
authors: D A
authors: DA
authors: Moraes
authors: M C
authors: MC
authors: Oliveira
authors: A B P L
authors: AB
authors: Stracieri
authors: F
authors: F
authors: Pieroni
authors: G M N
authors: GM
authors: Barros
authors: M I A
authors: MI
authors: Madeira
authors: B P
authors: BP
authors: Simões
authors: A A
authors: AA
authors: Barreira
authors: D G
authors: DG
authors: Brum
authors: A A F
authors: AA
authors: Ribeiro
authors: J M
authors: JM
authors: Kutner
authors: C P
authors: CP
authors: Tylberi
authors: P P
authors: PP
authors: Porto
authors: C L
authors: CL
authors: Santana
authors: J Z
authors: JZ
authors: Neto
authors: J C
authors: JC
authors: Barros
authors: A T
authors: AT
authors: Paes
authors: R K
authors: RK
authors: Burt
authors: E A
authors: EA
authors: Oliveira
authors: A P
authors: AP
authors: Mastropietro
authors: A C
authors: AC
authors: Santos
authors: J C
authors: JC
authors: Voltarelli
mesh_terms: D000328:Adult; D000818:Animals; D000961:Antilymphocyte Serum / Q000008:administration & dosage; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage; D002330:Carmustine / Q000008:administration & dosage; D003561:Cytarabine / Q000008:administration & dosage; D005047:Etoposide / Q000008:administration & dosage; D005260:Female; D006084:Graft Rejection / Q000517:prevention & control; D019650:Hematopoietic Stem Cell Mobilization; D018380:Hematopoietic Stem Cell Transplantation / Q000379:methods*; D006736:Horses; D006801:Humans; D008297:Male; D008558:Melphalan / Q000008:administration & dosage; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000628:therapy*; D011788:Quality of Life; D011817:Rabbits; D019172:Transplantation Conditioning / Q000379:methods*
chemical_list: D000961:Antilymphocyte Serum; D003561:Cytarabine; D005047:Etoposide; D008558:Melphalan; D002330:Carmustine