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| T cell-depleted autologous hematopoietic stem cell transplantation for multiple sclerosis: report on the first three patients |
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| Author(s): Burt RK, Traynor AE, Cohen B, Karlin KH, Davis FA, Stefoski D, Terry C, Lobeck L, Russell EJ, Goolsby C, Rosen S, Gordon LI, Keever-Taylor C, Brush M, Fishman M, Burns WH |
| Source: BONE MARROW TRANSPLANTATION Volume: 21 Issue: 6 Pages: 537-541 Published: MAR 1998 |
| Times Cited: 60 References: 16 |
| Abstract: Multiple sclerosis (MS) is a disease of the central nervous system characterized by immune-mediated destruction of myelin, In patients with progressive deterioration, we have intensified immunosuppression to the point of myeloablation. Subsequently, a new hematopoietic and immune system is generated by infusion of CD34-positive hematopoietic stem cells (HSC), Three patients with clinical MS and a decline of their Kurtzke extended disability status scale (EDSS) by 1.5 points over the 12 months preceding enrollment and a Kurtzke EDSS of 8.0 at the time of enrollment were treated with hematopoietic stem cell (HSC) transplantation using a myeloablative conditioning regimen of cyclophosphamide (120 mg/kg), methylprednisolone (4 g) and total body irradiation (1200 cGy), Reconstitution of hematopoiesis was achieved with CD34-enriched stem cells, The average time of follow-up is 8 months (range 6-10 months), Despite withdrawal of all immunosuppressive medications, functional improvements have occurred in all three patients, We conclude that T cell-depleted hematopoietic stem cell transplantation can be performed safely in patients with severe and debilitating multiple sclerosis, Stem cell transplantation has resulted in modest neurologic improvements for the first time since onset of progressive disease although no significant changes in EDSS or NRS scales are evident at this time. |
| Document Type: Article |
| Language: English |
| Reprint Address: Burt, RK (reprint author), , Wesley Pavil,Room 1416,250 E Super St, Chicago, IL 60611 USA |
Addresses:
1. Northwestern Univ, Sch Med, Dept Med, Div Hematol Oncol, Chicago, IL 60611 USA
2. Northwestern Univ, Sch Med, Dept Neurol, Chicago, IL 60611 USA
3. Northwestern Univ, Sch Med, Dept Radiol, Chicago, IL 60611 USA
4. Robert H Lurie Canc Ctr, Chicago, IL USA
5. Rush Presbyterian St Lukes Med Ctr, Dept Neurol, Chicago, IL 60612 USA
6. Med Coll Wisconsin, Dept Neurol, Milwaukee, WI 53226 USA
7. Med Coll Wisconsin, Dept Med, Div Hematol Oncol, Milwaukee, WI 53226 USA |
| Publisher: STOCKTON PRESS, HOUNDMILLS, BASINGSTOKE RG21 6XS, HAMPSHIRE, ENGLAND |
| Subject Category: Biophysics; Oncology; Hematology; Immunology; Transplantation |
| IDS Number: ZD120 |
| ISSN: 0268-3369 |
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