Skip to main content
SpringerLink
Log in

Effect of intensive immunosuppression on the course of chronic progressive multiple sclerosis

  • Original Investigations
  • Published:
Journal of Neurology Aims and scope Submit manuscript

Summary

39 patients with chronic-progressive multiple sclerosis were treated with a short course of intensive immunosuppression consisting in high doses of cyclophosphamide and prednisone. The follow-up period varied between 1 and 5 years with a mean of 21/2 years. Progression of the disease ceased in 27 patients for varying periods, with a mean of two years. In 13 patients the progression ceased during the whole follow-up period.

The treatment gave the most favourable results in patients who were DRw2 positive in histocompatibility testing, whose disease started at an early age (around 28 years), whose disease duration before treatment was short (6 years), whose progression was fast and whose disability before treatment was low. If CSF levels of IgG 3 months after the treatment remain low, this is a sign of good prognosis.

Zusammenfassung

39 Patienten mit chronisch progressiver Multipler Sklerose wurden während drei Wochen mit intensiver Immunosuppression behandelt (Cyclophosphamide und Prednison). Die Kontrollperiode wechselte zwischen 1 und 5 Jahren mit einem Mittelwert von 21/2 Jahren. Die Progression der Krankheit wurde gestoppt bei 27 Patienten während durchschnittlich 2 Jahren. Bei 13 Patienten dauerte die Verbesserung während der ganzen Observationsperiode an.

Die Behandlung ergab den besten Erfolg bei jüngeren Patienten mit DRw2-positivem HLA-Test und kurzer Krankheitsdauer, deren Progression schnell und deren Invalidität niedrig war. Wenn das IgG-Niveau 3 Monate nach der Behandlung niedrig blieb, war das ein Zeichen einer guten Prognose.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  • Bauer, H. J., Firnhaber, W., Winkler, W.: Prognostic criteria in multiple sclerosis. Ann. N.Y. Acad. Sci. 122, 542–551 (1965)

    Google Scholar 

  • Berg-Loonen, E. M. van den, Lucas, K. J.: LD7a typing in 46 patients with multiple sclerosis. In: Histocompatibility testing, pp. 773–777. Copenhagen: Munksgaard 1975

    Google Scholar 

  • Bertrams, J., Kuwert, E., Grosse-Wilde, H., Mempel, W.: Disease susceptibility genotype for multiple sclerosis. Z. Immun. Forsch. 148, 383–387 (1975)

    Google Scholar 

  • Bodmer, W. F., Batchelor, J. F., Bodmer, J. G., Festenstein, H., Morris, P. J.: HLA and disease. Multiple sclerosis, pp. 207–210. Copenhagen: Munksgaard 1977

    Google Scholar 

  • Confavreux, C.: L'histoire naturelle de la sclérose en plaques. Étude par informatique de 349 observations. Thèse Lyon. 1977

  • Degos, L., Dausset, J.: Histocompatibility determinants in multiple sclerosis. Lancet 1974I, 307–308

    Google Scholar 

  • Delmotte, P., Hommes, O. R., Gonsette, R.: Immunosuppressive treatment in multiple sclerosis, p. 224. Gent, Belgium: European Press 1977

    Google Scholar 

  • Delpech, B., Lichtblau, E.: Étude quantitative des immunoglobulines G et de l'albumine du liquide céphalo-rachidien. Clin. Chim. Acta 37, 15–23 (1972)

    Google Scholar 

  • Frick, E., Scheid-Seydel, L.: Untersuchungen mit 131J-markierten γ-Globulin zur Frage der Abstammung der Liquoreiweißkörper. Klin. Wochenschr. 36, 857–863 (1958)

    Google Scholar 

  • Ganrod, K., Laurell, C. B.: Measurement of IgG and albumin content of cerebrospinal fluid and its interpretation. Clin. Chem. 20, 571–573 (1974)

    Google Scholar 

  • Grosse-Wilde, H., Bertrams, J., Schuppien, W., Netzel, B., Ruppelt, W., Kuwert, E. K.: HLA-D typing in 111 multiple sclerosis patients: distribution of four HLA-D alleles. Immunogenetics 4, 481–488 (1977)

    Google Scholar 

  • Hommes, O. R., Lamers, K. J. B., Reekers, P.: Assessment of process activity in multiple sclerosis and changes in spinal fluid. Progress in MS research. Proceedings of the IFMSS Symposium 1978. Göttingen, Berlin: Springer 1980 (in press)

    Google Scholar 

  • Jersild, G., Fog, T., Hansen, G. S., Thomsen, M., Svejgaard, A., Dupont, B.: Histocompatibility determinants in multiple sclerosis with special references to clinical course. Lancet 1973II, 1221–1224

    Google Scholar 

  • Kurtzke, J. F.: Course of exacerbations of multiple sclerosis in hospitalized patients. Arch. Neurol. Psych. 76, 175–184 (1956)

    Google Scholar 

  • Lamers, K. J. B., Hommes, O. R., Kok, J. C. N.: Cerebrospinal fluid IgG in multiple sclerosis patients during and after intensive immunosuppressive treatment. In: Immunosuppressive treatment in multiple sclerosis, P. Delmotte, O. R. Hommes and R. Gonsette (eds.), pp. 182–194. Gent, Belgium: European Press 1977

    Google Scholar 

  • McAlpine, D., Compston, N.: Some aspects of the natural history of disseminated sclerosis. Quart. J. Med. 21, 135–167 (1952)

    Google Scholar 

  • McAlpine, D., Lumsden, C. E., Acheson, E. D.: Multiple sclerosis. A reappraisal, p. 415. Edinburgh/London: Livingstone 1965

    Google Scholar 

  • Poser, S., Wikström, J., Bauer, H. J.: Clinical data and identification of special forms of multiple sclerosis in 1271 cases studied with a standardized documentation system. J. Neurol. Sci. 40, 159–168 (1979)

    Google Scholar 

  • Reekers, P., Hommes, O. R., Creemers-Molenaar, J., Wijnings, J., Kunst, V. A. M., Rood, J. J. van: HLA-typing and lymphocyte population studies in patients with multiple sclerosis. J. Neurol. Sci. 33, 143–153 (1977)

    Google Scholar 

  • Rose, A. S.: Cooperative study in the evaluation of therapy in multiple sclerosis. Neurology 20, part 2, 1 (1968)

    Google Scholar 

  • Schauf, C. L., Schauf, V., Davis, A. J., Strelkauskas, A. J., Mizen, M. R.: Lymphocyte subpopulations in multiple sclerosis: comparison with neuroelectric blocking activity. Neurology 27, 822–826 (1977)

    Google Scholar 

  • Schumacher, G. A.: Critique of experimental trials of therapy in multiple sclerosis. Neurology 24, 1010–1014 (1974)

    Google Scholar 

  • Schumacher, G. A., Beebe, G., Kibler, R. F., Kurland, L. T., Kurtzke, J. F., Macdowell, F., Nagler, B., Sibley, W. A., Tourtelotte, W. W., Wilson, T. L.: Problems of experimental trials of therapy in multiple sclerosis. Ann. N.Y. Acad. Sci. 122, 552–568 (1965)

    Google Scholar 

  • Straten, A. H. van, Pauw, B. E. de, Geestman, E. J. M., Smeulders, J. B. J. M., Wagener, D. J. Th., Hommes, O. R.: Density distribution profile and spontaneous transformation of lymphocytes in multiple sclerosis (to be published)

  • Tourtelotte, W. W.: On cerebrospinal fluid immuno-globulin-G (IgG) quotients in multiple sclerosis and other diseases. J. Neurol. Sci. 10, 279–304 (1970)

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Neurology, Radboud University Hospital, Reinier Postlaan 4, Nijmegen, The Netherlands

    O. R. Hommes & K. J. B. Lamers

  2. Blood Transfusion Service, Radboud University Hospital, Nijmegen, The Netherlands

    P. Reekers

Authors
  1. O. R. Hommes
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. K. J. B. Lamers
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. P. Reekers
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Hommes, O.R., Lamers, K.J.B. & Reekers, P. Effect of intensive immunosuppression on the course of chronic progressive multiple sclerosis. J. Neurol. 223, 177–190 (1980). https://doi.org/10.1007/BF00313182

Download citation

  • Received:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF00313182

Key words

Search

Navigation