Neurological Sciences

, 30:167 | Cite as

Mitoxantrone: benefits and risks in multiple sclerosis patients

  • V. Martinelli
  • M. Radaelli
  • L. Straffi
  • M. Rodegher
  • G. Comi
MS Treatment


Mitoxantrone (MTX) is a synthetic antineoplastic cytotoxic drug, active both on proliferative and non-proliferative cells. The efficacy of MTX has been suggested by many open-label or observational studies and demonstrated in four randomized controlled clinical trials (RCTs). It is indicated for reducing neurological disability and the frequency of clinical relapses in patients with progressive relapsing and worsening relapsing–remitting MS patients. The short-term most frequent adverse events observed in RCTs have been nausea/vomiting, alopecia, an increased risk of urinary and respiratory tract infections, phlebitis, transitory leukopenia, amenorrhea in female patients and infertility. However, the most serious risks of the drug are represented by potential cardiotoxicity and leukaemia, whose incidence seems to be higher than previously reported. Therefore, all potential serious adverse events should be carefully considered against the potential relevant benefits of MTX treatment on every single MS patient.


Mitoxantrone Multiple sclerosis Adverse events Leukaemia 


Conflict of interest statement

The authors declare that they have no conflict of interest related to the publication of this article.


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Copyright information

© Springer-Verlag 2009

Authors and Affiliations

  • V. Martinelli
    • 1
  • M. Radaelli
    • 1
  • L. Straffi
    • 1
  • M. Rodegher
    • 1
  • G. Comi
    • 1
  1. 1.Neurology Department, INSPEUniversity IRCCS San RaffaeleMilanItaly

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