title: Brain pathology of a patient 7years after autologous hematopoietic stem cell transplantation for multiple sclerosis.
abstract: Aggressive immunosuppression followed by autologous hematopoietic stem cell transplantation (aHSCT) can be an effective treatment for severe multiple sclerosis (MS), but not all stages of disease may benefit equally. The case of a 49-year-old woman with advanced secondary-progressive MS whose clinical course was not improved by aHSCT and who seven years after transplantation succumbed to complications of severe MS disease-related disability is presented. Autopsy findings of ongoing neurodegeneration despite only rare infiltrating T-lymphocytes illustrate that late MS disease may not represent a suitable disease stage for aHSCT.
authors.affiliation: University of Washington, Seattle, WA, USA. Electronic address: awundes@uw.edu.
authors.forename: Annette
authors.initials: A
authors.lastname: Wundes
authors.affiliation: Swedish Neuroscience Institute, Seattle, WA, USA.
authors.forename: James D
authors.initials: JD
authors.lastname: Bowen
authors.affiliation: University of Washington, Seattle, WA, USA.
authors.forename: George H
authors.initials: GH
authors.lastname: Kraft
authors.affiliation: University of Washington, Seattle, WA, USA.
authors.forename: Kenneth R
authors.initials: KR
authors.lastname: Maravilla
authors.affiliation: Fred Hutchinson Cancer Research Center, Seattle, WA, USA.
authors.forename: Bernadette
authors.initials: B
authors.lastname: McLaughlin
authors.affiliation: University of Washington, Seattle, WA, USA.
authors.forename: Gloria
authors.initials: G
authors.lastname: von Geldern
authors.affiliation: Fred Hutchinson Cancer Research Center, Seattle, WA, USA.
authors.forename: George
authors.initials: G
authors.lastname: Georges
authors.affiliation: Colorado Blood Cancer Institute, Denver, CO, USA.
authors.forename: Richard A
authors.initials: RA
authors.lastname: Nash
authors.affiliation: University of Alberta, Department of Pathology, Edmonton, Alberta, Canada.
authors.forename: Jian-Qiang
authors.initials: JQ
authors.lastname: Lu
mesh_terms: D064592:Autografts; D001921:Brain / Q000473:pathology*; D017809:Fatal Outcome; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D008875:Middle Aged; D020528:Multiple Sclerosis, Chronic Progressive / Q000473:pathology* / Q000628:therapy*; D016896:Treatment Outcome; D066127:White Matter / Q000473:pathology
keywords: Demyelination; Multiple sclerosis; Neurodegeneration; Neuropathology; Stem cell transplantation