Real-world application of autologous hematopoietic stem cell transplantation in 507 patients with multiple sclerosis.

Real-world application of autologous hematopoietic stem cell transplantation in 507 patients with multiple sclerosis.

Publication date: Oct 11, 2021

To investigate the results of real-world application of non-myeloablative autologous HSCT for multiple sclerosis (MS). Between July 2003 and October 2019 at a single center (Northwestern University), 414 patients with relapsing remitting MS (RRMS) and 93 patients with newly diagnosed secondary progressive MS (SPMS) underwent non-myeloablative HSCT. There was one treatment-related death (0. 19%) due to hospital-acquired legionella pneumonia, and one patient developed neutropenic bacteremia (Klebsiella pneumonia) without sepsis. Overall 5-year survival was 98. 8%. Post HSCT secondary autoimmune diseases (2nd ADs) were idiopathic thrombocytopenia (ITP) and hypo or hyperthyroidism. ITP was highest with alemtuzumab (14%) and 0 to 2. 8% for the non-alemtuzumab regimens. After HSCT, 16 patients developed hypothyroidism (3. 5%) and 15 developed hyperthyroidism / Grave’s disease (3. 3%). Relapse free survival (RFS) at 5 years for RRMS and SPMS was 80. 1% and 98. 1%, respectively, while progression free survival (PFS) at 4 years for RRMS and SPMS was 95% versus 66%, respectively. For patients with RRMS, the EDSS significantly improved (p 

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Concepts Keywords
July Spms
Northwestern Alemtuzumab
Pneumonia Transplantation medicine
Thrombocytopenia Lymphology
University Surgical oncology
Multiple sclerosis
Clinical medicine
Medical specialties
HSCT
Relapsing–remitting
Transplantation

Semantics

Type Source Name
disease MESH Relapsing remitting multiple sclerosis
disease MESH sclerosis
disease MESH Relapse
disease MESH hypothyroidism
drug DRUGBANK Alemtuzumab
disease MESH hyperthyroidism
disease MESH thrombocytopenia
disease MESH autoimmune diseases
disease MESH sepsis
disease MESH bacteremia
disease MESH pneumonia
disease MESH death
disease MESH multiple sclerosis
disease MESH Secondary progressive multiple sclerosis
disease MESH treatment failure
disease MESH diagnosis
drug DRUGBANK Gadolinium
drug DRUGBANK Cyclophosphamide
drug DRUGBANK Dimethyltryptamine
disease MESH infection
disease MESH cerebellar ataxia
drug DRUGBANK Methionine
drug DRUGBANK Glatiramer
drug DRUGBANK Acetate ion
disease MESH immune diseases
disease MESH liver dysfunction
disease MESH hepatitis
disease MESH cancer
disease MESH encephalopathy
drug DRUGBANK Natalizumab
drug DRUGBANK Dimethyl fumarate
drug DRUGBANK Rituximab
drug DRUGBANK Ocrelizumab
drug DRUGBANK Teriflunomide
drug DRUGBANK Cholestyramine
drug DRUGBANK Activated charcoal
drug DRUGBANK Immune Globulin Human
disease MESH diuretics
drug DRUGBANK Filgrastim
disease MESH idiopathic thrombocytopenic purpura
disease MESH sitting
drug DRUGBANK Midodrine
drug DRUGBANK Meticillin
drug DRUGBANK Vancomycin
drug DRUGBANK Roxithromycin
drug DRUGBANK Mupirocin
disease MESH sore throat
drug DRUGBANK Acyclovir
drug DRUGBANK Valaciclovir
drug DRUGBANK Fluconazole
drug DRUGBANK Trimethoprim
drug DRUGBANK Sulfamethoxazole
drug DRUGBANK Pentaerythritol tetranitrate
disease MESH viral load
drug DRUGBANK Valganciclovir
drug DRUGBANK Water
drug DRUGBANK Ciprofloxacin
disease MESH mucormycosis
drug DRUGBANK Cefepime
drug DRUGBANK Piperacillin
drug DRUGBANK Methylprednisolone
disease MESH neurologic symptoms
drug DRUGBANK Trestolone
disease MESH complications
disease MESH cerebrovascular accident
disease MESH medication non compliance
disease MESH myocardial infarction
disease MESH colon cancer
disease MESH lymphoma
disease MESH myelodysplastic syndrome
disease MESH leukemia
disease MESH bladder cancer
pathway KEGG Bladder cancer
disease MESH respiratory tract infections
disease MESH sinusitis
disease MESH candidiasis
disease MESH cystitis
drug DRUGBANK Nitazoxanide
disease MESH bacterial infection
disease MESH varicella
disease MESH neuromyelitis optica
drug DRUGBANK Interferon beta-1a
drug DRUGBANK Fingolimod
drug DRUGBANK Mitoxantrone
drug DRUGBANK Daclizumab
drug DRUGBANK Cladribine
drug DRUGBANK Mycophenolate mofetil
drug DRUGBANK Azathioprine
drug DRUGBANK Methotrexate
disease MESH Otitis media
disease MESH Influenza
disease MESH Parainfluenza
disease MESH Urinary tract infections
disease MESH EBV infection
drug DRUGBANK Coenzyme M
disease MESH separated
disease MESH neutropenia
disease MESH mucositis
disease MESH viral infection
disease MESH sterility
drug DRUGBANK Busulfan
drug DRUGBANK Spinosad
drug DRUGBANK Trihexyphenidyl
disease MESH inflammation

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