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Autologous haematop...
Autologous haematopoietic stem cell transplantation: a viable treatment option for CIDP
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- Press, R (author)
- Karolinska Institutet
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- Askmark, Håkan (author)
- Uppsala universitet,Neurologi
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- Svenningsson, Anders (author)
- Umeå universitet,Klinisk neurovetenskap
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- Andersen, Oluf, 1941 (author)
- Gothenburg University,Göteborgs universitet,Institutionen för neurovetenskap och fysiologi, sektionen för klinisk neurovetenskap och rehabilitering,Institute of Neuroscience and Physiology, Department of Clinical Neuroscience and Rehabilitation
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- Axelson, Hans W (author)
- Uppsala universitet,Klinisk neurofysiologi
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- Strömberg, U (author)
- Uppsala universitet,Hematologi
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- Wåhlin, Anders (author)
- Umeå universitet,Radiofysik
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Isaksson, C (author)
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Johansson, J-E (author)
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- H, Hägglund (author)
- Karolinska Institutet,Uppsala universitet,Hematologi
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(creator_code:org_t)
- 2013-11-21
- 2014
- English.
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In: Journal of Neurology, Neurosurgery and Psychiatry. - : BMJ. - 0022-3050 .- 1468-330X. ; 85:6, s. 618-624
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Abstract
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- OBJECTIVE: Only 70-80% of patients with chronic inflammatory demyelinating polyneuropathy (CIDP) respond satisfactorily to the established first-line immunomodulatory treatments. Autologous haematopoietic stem cell transplantation (AHSCT) has been performed as a last treatment resort in a few therapy-refractory cases with CIDP. We describe the results of AHSCT in 11 consecutive Swedish patients with therapy-refractory CIDP with a median follow-up time of 28 months. METHOD: Case data were gathered retrospectively for AHSCT treatments in 11 patients with CIDP refractory to the first-line immunomodulatory treatments, intravenous high-dose immunoglobulin, corticosteroids and plasma exchange and to one or more second-line treatments used in 10 of the 11 patients. RESULTS: The median Inflammatory Neuropathy Cause and Treatment (INCAT) score within 1 month prior to AHSCT was 6 and the Rankin score 4. Total INCAT and Rankin scores improved significantly within 2-6 months after AHSCT and continued to do so at last follow-up. The motor action potential amplitudes (CMAP) improved already within 4 months (median) after AHSCT. Three of the 11 patients relapsed during the follow-up period, requiring retransplantation with AHSCT in one. Eight of the 11 patients maintained drug-free remission upon last follow-up. AHSCT was safe but on the short term associated with a risk of cytomegalovirus (CMV) and Epstein-Barr virus reactivation, CMV disease, haemorrhagic cystitis and pancreatitis. CONCLUSIONS: Our results though hampered by the limited number of patients and the lack of a control group suggest AHSCT to be efficacious in therapy-refractory CIDP, with a manageable complication profile. Confirmation of these results is necessary through randomised controlled trials.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Neurologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Neurology (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Medicinsk bioteknologi -- Medicinsk bioteknologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Medical Biotechnology -- Medical Biotechnology (hsv//eng)
Keyword
- CIDP
- therapy
- stem cell transplantation
Publication and Content Type
- ref (subject category)
- art (subject category)
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- By the author/editor
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Press, R
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Askmark, Håkan
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Svenningsson, An ...
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Andersen, Oluf, ...
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Axelson, Hans W
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Strömberg, U
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show more...
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Wåhlin, Anders
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Isaksson, C
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Johansson, J-E
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H, Hägglund
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show less...
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- MEDICAL AND HEALTH SCIENCES
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and Clinical Medicin ...
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MEDICAL AND HEAL ...
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and Clinical Medicin ...
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and Neurology
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MEDICAL AND HEAL ...
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and Medical Biotechn ...
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- Articles in the publication
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Journal of Neuro ...
- By the university
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University of Gothenburg
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Uppsala University
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Karolinska Institutet
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Umeå University