High-dose chemotherapy with autologous hematopoietic stem cell transplantation in multiple sclerosis: intermediate results of 3 years research

Abstract

Relevance. Multiple sclerosis (MS) is a chronic demyelinating autoimmune disease of the central nervous system with progressive course. High-dose chemotherapy (HDCT) with autologous haematopoietic stem cell transplantation (AHSCT) is a promising course of treatment-refractory MS. The study aimed to assess the effi cacy and safety of treating MS patients with HDCT + AHSCT.Material and methods. Were studied 10 people (5 women and 5 men) with relapsing-remitting (30%), secondary progressive (60%) and primary progressive MS (10%). Patients underwent AHSCT using cyclophosphamide + rituximab chemotherapeutic regimen.Results. In 90% of cases, at least a stabilizing eff ect is shown after the procedure. Only 10% was showed signs of demyelinating activity on MRI of the spinal cord 2 years after HDCT + AHSCT. All patients had a response to therapy according to median Expanded Disability Status Scores (EDSS). We found a positive dynamics of the average EDSS score: before treatment — 5.9 points, 6 months and 1 year after treatment — 5.1 points. There was shown a positive eff ect on dynamics of neurological status, quality of life and emotional state of patients. No treatment-related mortality and uncontrolled complications were revealed.Conclusion. Timely AHSCT contributes to minimizing the level of disability and signifi cantly improves the quality of life of patients.