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Acta Neurol Scand. 2019 Nov;140(5):320-327. doi: 10.1111/ane.13147. Epub 2019 Aug 5.

Sustained remission in multiple sclerosis after hematopoietic stem cell transplantation.

Author information

1
Department of Neuroscience, Uppsala University, Uppsala, Sweden.
2
Department of Medical Sciences, Uppsala University, Uppsala, Sweden.
3
Section of Clinical Chemistry and Pharmacology, Uppsala University Hospital, Uppsala, Sweden.
4
Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
5
Division of Neuroradiology, Department of Radiology, Karolinska University Hospital, Stockholm, Sweden.
6
Department of Surgical Sciences/Radiology, Uppsala University, Uppsala, Sweden.

Abstract

OBJECTIVES:

To determine whether treatment with autologous hematopoietic stem cell transplantation (HSCT) can induce sustained complete remission in patients with multiple sclerosis (MS).

MATERIAL AND METHODS:

Case series of patients with relapsing-remitting MS (n = 10) treated at a single center between 2004 and 2007 and followed up for 10 years. The patients were treated with a BEAM/ATG conditioning regimen (n = 9) or a cyclophosphamide/ATG conditioning regimen (n = 1) followed by infusion of unmanipulated autologous hematopoietic stem cells. The primary endpoint was sustained complete remission. Sustained complete remission was defined as "no evidence of disease activity-4," sustained for a period of at least 5 years without any ongoing disease-modifying treatment. Furthermore, MS was considered as "resolved" if intrathecal IgG production and cerebrospinal fluid neurofilament light levels were normalized as well.

RESULTS:

Five out of 10 patients were in sustained complete remission at the end of the study. In three of them, MS was resolved.

CONCLUSIONS:

Our data demonstrate that sustained complete remission after autologous HSCT for MS is possible.

KEYWORDS:

cerebrospinal fluid; hematopoietic stem cell transplantation; magnetic resonance imaging; multiple sclerosis

PMID:
31297793
DOI:
10.1111/ane.13147

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