1. |
- Burman, Joachim, et al.
(författare)
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Autologous haematopoietic stem cell transplantation for aggressive multiple sclerosis : the Swedish experience
- 2014
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Ingår i: Journal of Neurology, Neurosurgery and Psychiatry. - London, United Kingdom : BMJ Publishing Group Ltd. - 0022-3050 .- 1468-330X. ; 85:10, s. 1116-1121
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Tidskriftsartikel (refereegranskat)abstract
- Background: Autologous haematopoietic stem cell transplantation (HSCT) is a viable option for treatment of aggressive multiple sclerosis (MS). No randomised controlled trial has been performed, and thus, experiences from systematic and sustained follow-up of treated patients constitute important information about safety and efficacy. In this observational study, we describe the characteristics and outcome of the Swedish patients treated with HSCT for MS.Methods: Neurologists from the major hospitals in Sweden filled out a follow-up form with prospectively collected data. Fifty-two patients were identified in total; 48 were included in the study and evaluated for safety and side effects; 41 patients had at least 1 year of follow-up and were further analysed for clinical and radiological outcome. In this cohort, 34 patients (83%) had relapsing-remitting MS, and mean follow-up time was 47 months.Results: At 5 years, relapse-free survival was 87%; MRI event-free survival 85%; expanded disability status scale (EDSS) score progression-free survival 77%; and disease-free survival (no relapses, no new MRI lesions and no EDSS progression) 68%. Presence of gadolinium-enhancing lesions prior to HSCT was associated with a favourable outcome (disease-free survival 79% vs 46%, p=0.028). There was no mortality. The most common long-term side effects were herpes zoster reactivation (15%) and thyroid disease (8.4%).Conclusions: HSCT is a very effective treatment of inflammatory active MS and can be performed with a high degree of safety at experienced centres.
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2. |
- Fagius, Jan, et al.
(författare)
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Hemisfärernas musik – ur barnets perspektiv : Barn kan och vill sjunga
- 2022
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Ingår i: Socialmedicinsk Tidskrift. - 0037-833X. ; 99:5-6, s. 684-696
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Tidskriftsartikel (refereegranskat)abstract
- Barn kan tillgodogöra sig musik. Nyfödda barn uppmärksammar musik; prematura barns näringsintag effektiviseras av vaggsång; föredrar konsonant harmoniserad musik framför dissonans; föredrar skalor med olikstora skalsteg framför ”falskklingande” skala med sju likstora tonsteg. Hos 4 dagar gamla spädbarn aktiveras hjärnan på likartat sätt som hos vuxna vid åhörandet av musik harmoniserad enligt musikalisk syntax, medan syntaxbrott ger ”kaotiskt” aktiveringsmönster. Spädbarn avstressas av tilltalet ”mödriska” och än mera av vaggsång. – Småbarn vill sjunga. Sånglusten bör välkomnas, på barnets fysiologiska villkor. Stämbanden är korta och vulnerabla. Barnets spontana tonläge ligger högre än den vuxnes; vid gemensam sång måste ett för barnet bekvämt tonläge väljas. Om barnet försöker imitera den vuxnes tonläge uppkommer pratsång, som försvårar barnets sångliga utveckling och kan skada rösten. Kungl. Musikaliska Akademien driver ett angeläget projekt om Sjungande barn (https://www.sjungandebarn.se).
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3. |
- Killestein, Joep, et al.
(författare)
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Antibody-Mediated suppression of Vbeta5.2/5.3+ T Cells in Multiple Sclerosis : Results from an MRI-Monitored Phase II Clinical Trial
- 2002
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Ingår i: Annals of Neurology. - : Wiley. - 0364-5134 .- 1531-8249. ; 51, s. 467-
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Tidskriftsartikel (refereegranskat)abstract
- The objective of this study was to evaluate the safety and efficacy of the humanized antibody ATM-027 in a baseline versus treatment magnetic resonance imaging-monitored study. Expansion of Vß5.2/5.3+ T cells has been demonstrated in the peripheral blood, cerebrospinal fluid, and brain lesions of MS patients. In a phase I study, ATM-027 depleted these cells in peripheral blood and, in parallel, T-cell MBP reactivity and IFN-? expression were reduced. We studied 59 patients with relapsing-remitting MS (47 on ATM-027 and 12 on placebo) stratified for HLA-DR2 status. Monthly intravenous injections were given for 6 months. Individual dose titration was employed to obtain depletion of the target T-cell level and downregulation of antigen receptor density as monitored by flow cytometry. Five monthly magnetic resonance imaging scans were performed before treatment to establish baseline activity, six during treatment, and three during follow-up. Additional immunological assessments were performed to elucidate the mechanism of action of ATM-027. The treatment was safe and well tolerated, inducing consistent suppression of the target cell population. During run-in, active lesions were found in 78.7% (37/47) of patients treated with ATM-027. During treatment, the median number of lesions was reduced by 33% (p = 0.13) independent of DR2 status. The corresponding volume of enhancement was 221 mm3 at baseline, with a reduction of 10% during treatment. Decreased numbers of cells expressing interferon-? messenger RNA, and decreased T-cell reactivity to several myelin antigens were found in ATM-027 treated patients. In conclusion, consistent suppression of Vß 5.2/5.3+ T cells was achieved. However, the effect size on magnetic resonance imaging was considerably less than the targeted 60%.
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4. |
- Malm, Jan, et al.
(författare)
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Neurologisk symtomlära
- 2006
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Ingår i: Internmedicin. - : Liber AB, Stockholm. - 9147052961 ; , s. 55-77, s. 568-
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Bokkapitel (populärvet., debatt m.m.)
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5. |
- Norrving, Bo, et al.
(författare)
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Cerebrovaskulära sjukdomar
- 2006
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Ingår i: Neurologi. - 9147053135 ; , s. 188-188
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Bokkapitel (övrigt vetenskapligt/konstnärligt)
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6. |
- Silfverberg, Thomas, et al.
(författare)
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Haematopoietic stem cell transplantation for treatment of relapsing-remitting multiple sclerosis in Sweden: an observational cohort study
- 2023
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Ingår i: Journal of Neurology Neurosurgery and Psychiatry. - : BMJ Publishing Group Ltd. - 0022-3050 .- 1468-330X.
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundA growing evidence base supports the use of autologous haematopoietic stem cell transplantation (aHSCT) for treatment of relapsing-remitting multiple sclerosis (RRMS), but it has not yet been integrated into most national clinical guidelines. The objective of this study was to assess efficacy and safety when aHSCT is implemented in routine healthcare.MethodsWe assessed 231 patients and the final analysis included 174 RRMS patients who were treated with aHSCT in Sweden before 1 January 2020. Efficacy was evaluated by performing a retrospective analysis of prospectively collected data from the Swedish MS registry. Procedure-related safety was assessed by analysing data from electronic patient records covering a period of 100 days following aHSCT.ResultsWith a median follow-up time of 5.5 (IQR: 3.4-7.5) years, the Kaplan-Meier estimate for no evidence of disease activity was 73% (95% CI 66% to 81%) at 5 years and 65% (95% CI 57% to 75%) at 10 years. Out of the 149 patients with baseline disability, 80 (54%) improved, 55 (37%) were stable and 14 (9%) deteriorated. The mean number of adverse events per patient was 1.7 (& PLUSMN;SD: 1.5) for grade 3 events and 0.06 (& PLUSMN;SD: 0.3) for grade 4 events. Febrile neutropenia was the most common adverse event, affecting 68% of patients. There was no treatment-related mortality.ConclusionsTreatment with aHSCT for RRMS is associated with freedom from disease activity in a majority of patients, with acceptable adverse events. This procedure should be considered a standard of care for patients with highly active RRMS.
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7. |
- Tedeholm, Helen, 1978, et al.
(författare)
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Time to secondary progression in patients with multiple sclerosis who were treated with first generation immunomodulating drugs
- 2013
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Ingår i: Multiple Sclerosis Journal. - : SAGE Publications (UK and US). - 1352-4585 .- 1477-0970. ; 19:6, s. 765-774
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Tidskriftsartikel (refereegranskat)abstract
- Background: It is currently unknown whether early immunomodulatory treatment in relapsing-remitting MS (RRMS) can delay the transition to secondary progression (SP). less thanbrgreater than less thanbrgreater thanObjective: To compare the time interval from onset to SP in patients with RRMS between a contemporary cohort, treated with first generation disease modifying drugs (DMDs), and a historical control cohort. less thanbrgreater than less thanbrgreater thanMethods: We included a cohort of contemporary RRMS patients treated with DMDs, obtained from the Swedish National MS Registry (disease onset between 1995-2004, n = 730) and a historical population-based incidence cohort (onset 1950-64, n = 186). We retrospectively analyzed the difference in time to SP, termed the "period effect" within a 12-year survival analysis, using Kaplan-Meier and Cox regression analysis. less thanbrgreater than less thanbrgreater thanResults: We found that the "period" affected the entire severity spectrum. After adjusting for onset features, which were weaker in the contemporary material, as well as the therapy initiation time, the DMD-treated patients still exhibited a longer time to SP than the controls (hazard ratios: men, 0.32; women, 0.53). less thanbrgreater than less thanbrgreater thanConclusion: Our results showed there was a longer time to SP in the contemporary subjects given DMD. Our analyses suggested that this effect was not solely driven by the inclusion of benign cases, and it was at least partly due to the long-term immunomodulating therapy given.
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8. |
- Aquilonius, Sten-Magnus, et al.
(författare)
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Den neurologiska undersökningen
- 2006
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Ingår i: Neurologi. - : Liber AB Stockholm. - 9147053135 ; , s. 568-
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Bokkapitel (övrigt vetenskapligt/konstnärligt)
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9. |
- Aquilonius, S-M, et al.
(författare)
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Den neurologiska undersökningen
- 2000
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Ingår i: Neurologi. - : Liber AB. ; , s. 58-
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Bokkapitel (övrigt vetenskapligt/konstnärligt)
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10. |
- Boivie, J, et al.
(författare)
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Yrsel
- 2006
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Ingår i: Neurologi. - 9147053135 ; , s. 485-485
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Bokkapitel (övrigt vetenskapligt/konstnärligt)
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