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Arch Neurol. 2010 Jun;67(6):716-22. doi: 10.1001/archneurol.2010.117.

Neuroinflammation and demyelination in multiple sclerosis after allogeneic hematopoietic stem cell transplantation.

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  • 1Department of Pathology and Laboratory Medicine, University of Calgary, Calgary, Alberta, Canada.

Abstract

OBJECTIVE:

To evaluate the effects of allogeneic hematopoietic stem cell transplantation (allo-HSCT) on the brains of persons with and without multiple sclerosis (MS) by means of postmortem histopathological examination.

DESIGN:

Postmortem histopathology, case studies, and case-control studies. Patients Four patients with MS who died at a median of 4.5 months (range, 3-9 months) after allo-HSCT for a concomitant hematologic malignant neoplasm; 5 patients without MS who died at a median of 10.0 months (1-29 months) after allo-HSCT; and 5 control subjects without MS who did not undergo allo-HSCT.

SETTING:

Referral centers. Intervention Allogeneic hematopoietic stem cell transplantation.

MAIN OUTCOME MEASURES:

Morphological features and immunohistochemical features, including the quantitative measures of chronic inflammatory cells.

RESULTS:

Demyelinating and inflammatory activities of MS persisted after allo-HSCT in all of the patients with MS. Active and chronic active MS lesions exhibited significantly higher numbers of CD3+ T cells and CD8+ cytotoxic T cells and significantly higher scores of CD68+ microglia/macrophages than did chronic inactive lesions or normal-appearing white matter. The normal-appearing brains of allo-HSCT recipients who did not have MS were found to have significantly higher numbers of CD3+ T cells and CD8+ cytotoxic T cells and higher scores of CD68+ microglia/macrophages compared with the controls; however, no demyelination was identified in these non-MS samples.

CONCLUSION:

Allo-HSCT fails to halt the demyelination and inflammation of MS.

PMID:
20558390
DOI:
10.1001/archneurol.2010.117
[PubMed - indexed for MEDLINE]
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