Acta Neurol Scand. 2019 Jul 12.

Sustained remission in multiple sclerosis after hematopoietic stem cell transplantation.

Tolf A1, Fagius J1, Carlson K2, ?kerfeldt T3, Granberg T4,5, Larsson EM6, Burman J1.

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Abstract

OBJECTIVES:
To determine if treatment with autologous hematopoietic stem cell transplantation 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 3 of them, MS was resolved.

CONCLUSIONS:
Our data demonstrate that sustained complete remission after autologous hematopoietic stem cell transplantation for MS is possible. This article is protected by copyright. All rights reserved.

https://www.ncbi.nlm.nih.gov/pubmed/31297793