Autologous Blood Stem Transplantation for progressive Multiple Sclerosis
KAZIS A, KAPINAS K. KIMISKIDIS VK, FASSAS A, ANAGNOSTOPOULOS A, SAKELLARI I, TSIMOUTROU V

Autologous BSCT is a novel treatment for severe autoimmune diseases, including progressive Multiple Sclerosis (p MS). We now present an interim analysis of our two pilot studies. In the first one, 15 patients with p MS treated with BEAM, autologous BSCT and Anti-thyroid Globulin (ATG) whereas in the second one, which included 9 further patients, additional CD34+ selection of the graft was performed. Median follow up is 30 months (range = 9-39). Out of 23 surviving patients 18 responded (18/23,78%) in the sense of getting improved or stabilised on EDSS whereas the remaining five progressed. Four out of these five patients had primary p MS. Out of 18 responders, 12 patients (12/23,52%) have maintained a stable condition whereas 6 developed relapses or slowly progressed after initial improvement. CD34+ selection appeared to give higher, albeit statistically non significant) percentage of patients maintaining a stable condition (75 vs 40%). However, it resulted in protent immunosuppression with the supsequent death of one patient due to aspergilosis (1/24,4%). Other adverse effects of BSCT include lever, allergy, bacteremia and transient neurotoxicity. These encouraging resulths await confirmation by a currently ongoing multicentre study of BSCT in MS.