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.
Lycke, JanDepartment of Neurology, Institute of Neuroscience and Physiology, Sahlgrenska University Hospital, Gothenburg, Sweden
(författare)
Gunnarsson, Martin,1973-Örebro universitet,Institutionen för läkarutbildning,Department of Neurology, Örebro University Hospital, Örebro, Sweden(Swepub:oru)mign
(författare)
Nilsson, PetraLund University,Lunds universitet,Neurologi, Lund,Sektion IV,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Neurology, Lund,Section IV,Department of Clinical Sciences, Lund,Faculty of Medicine,Skåne University Hospital Lund, Sweden(Swepub:lu)neur-pn8
(författare)
Vrethem, MagnusÖstergötlands Läns Landsting,Linköpings universitet,Avdelningen för neurovetenskap,Hälsouniversitetet,Neurologiska kliniken(Swepub:liu)magvr07
(författare)
Sandstedt, AnnaLinköpings universitet,Institutionen för samhälls- och välfärdsstudier,Hälsouniversitetet(Swepub:liu)annsa08
(författare)
Uggla, Bertil,1962-Örebro universitet,Institutionen för läkarutbildning,Region Örebro län,Division of Hematology, Department of Medicine, Örebro University Hospital, Örebro, Sweden(Swepub:oru)bua
(författare)
Lenhoff, StigLund University,Lunds universitet,Avdelningen för hematologi och transfusionsmedicin,Institutionen för laboratoriemedicin,Medicinska fakulteten,Division of Hematology and Transfusion Medicine,Department of Laboratory Medicine,Faculty of Medicine,Skåne University Hospital, Sweden(Swepub:lu)med-slf
(författare)
Johansson, Jan-Erik,1946-Department of Hematology and Coagulation, Sahlgrenska University Hospital, Gothenburg, Sweden(Swepub:oru)jkjn
(författare)
Isaksson, CeciliaUmeå universitet,Institutionen för strålningsvetenskaper
(författare)
Hägglund, HansKarolinska Institutet,Uppsala universitet,Hematologi,University of Uppsala Hospital, Sweden(Swepub:uu)hanha689
(författare)
Carlson, KristinaUppsala universitet,Hematologi,University of Uppsala Hospital, Sweden(Swepub:uu)krica965
(författare)
Fagius, JanUppsala universitet,Neurologi,Uppsala University, Sweden; University of Uppsala Hospital, Sweden(Swepub:uu)janfagiu
(författare)
Uppsala universitetNeurologi
(creator_code:org_t)
Sammanhörande titlar
Ingår i:Journal of Neurology, Neurosurgery and PsychiatryLondon, United Kingdom : BMJ Publishing Group Ltd85:10, s. 1116-11210022-30501468-330X