Neurological Sciences

, Volume 33, Issue 4, pp 881–886

Long-term efficacy of autologous haematopoietic stem cell transplantation in multiple sclerosis at a single institution in China

Authors

  • Bing Chen
    • Department of HematologyThe Affiliated Drum Tower Hospital of Nanjing University Medical School
    • Center of Bone Marrow TransplantationThe Affiliated Drum Tower Hospital of Nanjing University Medical School
  • Min Zhou
    • Department of HematologyThe Affiliated Drum Tower Hospital of Nanjing University Medical School
    • Center of Bone Marrow TransplantationThe Affiliated Drum Tower Hospital of Nanjing University Medical School
    • Department of HematologyThe Affiliated Drum Tower Hospital of Nanjing University Medical School
    • Center of Bone Marrow TransplantationThe Affiliated Drum Tower Hospital of Nanjing University Medical School
  • Rongfu Zhou
    • Department of HematologyThe Affiliated Drum Tower Hospital of Nanjing University Medical School
    • Center of Bone Marrow TransplantationThe Affiliated Drum Tower Hospital of Nanjing University Medical School
  • Jingyan Xu
    • Department of HematologyThe Affiliated Drum Tower Hospital of Nanjing University Medical School
    • Center of Bone Marrow TransplantationThe Affiliated Drum Tower Hospital of Nanjing University Medical School
  • Qiguo Zhang
    • Department of HematologyThe Affiliated Drum Tower Hospital of Nanjing University Medical School
    • Center of Bone Marrow TransplantationThe Affiliated Drum Tower Hospital of Nanjing University Medical School
  • Yonggong Yang
    • Department of HematologyThe Affiliated Drum Tower Hospital of Nanjing University Medical School
    • Center of Bone Marrow TransplantationThe Affiliated Drum Tower Hospital of Nanjing University Medical School
  • Yong Xu
    • Department of HematologyThe Affiliated Drum Tower Hospital of Nanjing University Medical School
    • Center of Bone Marrow TransplantationThe Affiliated Drum Tower Hospital of Nanjing University Medical School
  • Xiaoyan Shao
    • Department of HematologyThe Affiliated Drum Tower Hospital of Nanjing University Medical School
    • Center of Bone Marrow TransplantationThe Affiliated Drum Tower Hospital of Nanjing University Medical School
  • Li Meng
    • Department of HematologyThe Affiliated Drum Tower Hospital of Nanjing University Medical School
    • Center of Bone Marrow TransplantationThe Affiliated Drum Tower Hospital of Nanjing University Medical School
  • Jing Wang
    • Department of HematologyThe Affiliated Drum Tower Hospital of Nanjing University Medical School
    • Center of Bone Marrow TransplantationThe Affiliated Drum Tower Hospital of Nanjing University Medical School
  • Yun Xu
    • Department of NeurologyThe Affiliated Drum Tower Hospital of Nanjing University Medical School
  • Xiushi Ni
    • Department of NeurologyThe Affiliated Drum Tower Hospital of Nanjing University Medical School
  • Xueguang Zhang
    • Department of HematologyThe Affiliated Drum Tower Hospital of Nanjing University Medical School
    • Center of Bone Marrow TransplantationThe Affiliated Drum Tower Hospital of Nanjing University Medical School
Original Article

DOI: 10.1007/s10072-011-0859-y

Cite this article as:
Chen, B., Zhou, M., Ouyang, J. et al. Neurol Sci (2012) 33: 881. doi:10.1007/s10072-011-0859-y

Abstract

Autologous haematopoietic stem cell transplantation (AHSCT) is a promising treatment for multiple sclerosis (MS) patients who have not adequately responded to conventional therapies. We retrospectively evaluated the safety and long-term clinical outcome of AHSCT in MS patients in China. Twenty-five patients with various types of MS were treated with AHSCT. Peripheral blood stem cells were derived by leukapheresis after mobilized with granulocyte colony-stimulating factor. Then CD34+ cell selection of the graft was performed and anti-thymocyte globulin was given for T-cell depletion, with the conditioning regimen BEAM adopted and early and late toxicities recorded. Long-term responses were evaluated by the expanded disability status scale (EDSS), progression-free survival and gadolinium-enhanced magnetic resonance imaging scans. 10, 7 and 8 patients experienced neurological improvement, stabilization and progression, respectively. The median EDSS scores observed over 1-year follow-up after transplantation (5.5–7.0) were consistently lower than the baseline (8.0). The progression-free survival rate was 74, 65 and 48% at 3, 6 and 9 years post-transplant. 58% cases (7/12) had active lesions at baseline and all turned to inactive status in the years of follow-up. 25% cases (3/12) experienced progression after transplantation but had no active lesions in MRI over the whole follow-up period. 17% cases (2/12) without active lesions at baseline progressed active lesions in MRI. The major early toxicity resulted in fever and late toxicity caused transplantation-related mortality due to severe pneumonia and varicella-zoster virus hepatitis, respectively. AHSCT is a feasible treatment for severe MS and its long-term efficacy is favorable.

Keywords

Multiple sclerosisAutologous haematopoietic stem cell transplantation

Copyright information

© Springer-Verlag 2011