title: Efficacy and safety of mitoxantrone use in primary and secondary progressive multiple sclerosis - study site experience based on the therapy of 104 patients.
abstract: Mitoxantrone (MX) is used in patients with primary and secondary progressive as well as relapsing-remitting type of multiple sclerosis (PPMS, SPMS, RRMS). The objective of our project was to evaluate the efficacy and safety of MX use in patients with PPMS and SPMS.
  
  
  METHODS
  The retrospective study included 104 patients (mean age 54.2 ± 9.0), with PPMS (13.46%) and SPMS (86.54%) treated with MX. During single cycle of the MX therapy a dose of 12 mg/m2of body surface area was administered and next cycles every three months up to a total dose of 140 mg/m2were realized.
  
  
  RESULTS
  The course of the therapy was completed by 95 patients (91.34%) including 73 patients who received a scheduled whole dose. The average cumulative dose per patient was 75.2 mg/m2. Thirty-two patients reported nausea after MX administration, 20 revealed increase in the incidence of infection and 19 patients hair loss. Twenty-two patients discontinued therapy (seven patients because of the progress of disability). Independent risk factors for deterioration were: age and the form of PPMS (RR 1.56 [95% CI: 1.17-2.07] and RR 2.8 [95% CI: 1.08-7.21], respectively). Five patients revealed a asymptomatic decrease in EF value <50% or 10% in relation to the previous test.
  
  
  CONCLUSIONS
  MX therapy enables us to stabilize the disease without causing any significant side effects in most patients with progressive disease as compared to patients with primary progressive disease with a comparable safety profile. Larger benefits of MX therapy are associated with the patients with secondary progressive disease.
authors.affiliation: a Department of Neurolog, School of Health Sciences in Katowice , Medical University of Silesia , Katowice , Poland.|b Department of Neurology, Professor Leszek Giec Upper Silesian Medical Centre , Medical University of Silesia Hospital No. 7 , Katowice , Poland.
authors.forename: Anetta
authors.initials: A
authors.lastname: Lasek-Bal
authors.affiliation: b Department of Neurology, Professor Leszek Giec Upper Silesian Medical Centre , Medical University of Silesia Hospital No. 7 , Katowice , Poland.
authors.forename: Karina
authors.initials: K
authors.lastname: Bartoszek
authors.affiliation: a Department of Neurolog, School of Health Sciences in Katowice , Medical University of Silesia , Katowice , Poland.|b Department of Neurology, Professor Leszek Giec Upper Silesian Medical Centre , Medical University of Silesia Hospital No. 7 , Katowice , Poland.
authors.forename: Arkadiusz
authors.initials: A
authors.lastname: Steposz
authors.affiliation: a Department of Neurolog, School of Health Sciences in Katowice , Medical University of Silesia , Katowice , Poland.|b Department of Neurology, Professor Leszek Giec Upper Silesian Medical Centre , Medical University of Silesia Hospital No. 7 , Katowice , Poland.
authors.forename: Przemyslaw
authors.initials: P
authors.lastname: Puz
authors.affiliation: c Department of Radiation Oncology and Chemotherapy , Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology , Gliwice , Poland.
authors.forename: Wieslaw
authors.initials: W
authors.lastname: Bal
authors.affiliation: b Department of Neurology, Professor Leszek Giec Upper Silesian Medical Centre , Medical University of Silesia Hospital No. 7 , Katowice , Poland.
authors.forename: Zofia
authors.initials: Z
authors.lastname: Kazibutowska
mesh_terms: D000328:Adult; D000368:Aged; D000505:Alopecia / Q000139:chemically induced; D018450:Disease Progression; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008942:Mitoxantrone / Q000009:adverse effects / Q000627:therapeutic use*; D020528:Multiple Sclerosis, Chronic Progressive / Q000188:drug therapy*; D009325:Nausea / Q000139:chemically induced; D012008:Recurrence; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D008942:Mitoxantrone
keywords: Multiple sclerosis; adverse effects; mitoxantrone