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Impact of previous ...
Impact of previous disease-modifying treatment on safety and efficacy in patients with MS treated with AHSCT
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Kvistad, Silje Agnethe Stokke (författare)
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- Burman, Joachim (författare)
- Uppsala universitet,Institutionen för medicinska vetenskaper,Experimentell neurologi
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Lehmann, Anne Kristine (författare)
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- Tolf, Andreas (författare)
- Uppsala universitet,Institutionen för medicinska vetenskaper,Experimentell neurologi
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- Zjukovskaja, Christina (författare)
- Uppsala universitet,Institutionen för medicinska vetenskaper,Experimentell neurologi
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Melve, Guro Kristin (författare)
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Bø, Lars (författare)
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Torkildsen, Øivind (författare)
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(creator_code:org_t)
- 2022-05-04
- 2022
- Engelska.
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Ingår i: Journal of Neurology, Neurosurgery and Psychiatry. - : BMJ Publishing Group Ltd. - 0022-3050 .- 1468-330X. ; 93:8, s. 844-848
- Relaterad länk:
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https://doi.org/10.1...
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https://uu.diva-port... (primary) (Raw object)
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https://urn.kb.se/re...
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https://doi.org/10.1...
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Abstract
Ämnesord
Stäng
- Background: Autologous haematopoietic stem cell transplantation (AHSCT) is a highly effective treatment for multiple sclerosis (MS). The impact of previous long-lasting disease-modifying treatments (DMT) for safety and efficacy of AHSCT is unknown.Objective: To explore whether previous DMTs with long-lasting effects on the immune system (anti-CD20 therapy, alemtuzumab and cladribine) affect treatment-related complications, long-term outcome and risk of new MS disease activity in patients treated with AHSCT.Methods: Retrospective observational study of 104 relapsing remitting patients with MS treated by AHSCT in Sweden and Norway from 2011 to 2021, grouped according to the last DMT used ≤6 months prior to AHSCT. The primary outcomes were early AHSCT-related complications (mortality, neutropenic fever and hospitalisation length), long-term complications (secondary autoimmunity) and proportion of patients with No Evidence of Disease Activity (NEDA-3 status): no new relapses, no MRI activity and no disease progression during the follow-up.Results: The mean follow-up time was 39.5 months (range 1-95). Neutropenic fever was a common AHSCT-related complication affecting 69 (66%) patients. There was no treatment-related mortality. During the follow-up period, 20 patients (19%) were diagnosed with autoimmunity. Occurrence of neutropenic fever, hospitalisation length or secondary autoimmunity did not vary dependent on the last DMT used prior to AHSCT. A total of 84 patients (81%) achieved NEDA-3 status, including all patients (100%) using rituximab, alemtuzumab or cladribine before AHSCT.Conclusion: This study provides level 4 evidence that AHSCT in patients previously treated with alemtuzumab, cladribine or rituximab is safe and efficacious.
Ämnesord
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Neurologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Neurology (hsv//eng)
Nyckelord
- haematology
- multiple sclerosis
- Neurology
- Neurologi
Publikations- och innehållstyp
- ref (ämneskategori)
- art (ämneskategori)
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