Effect of open label pulse cyclophosphamide therapy on MRI measures of disease activity in five patients with refractory relapsing-remitting multiple sclerosis

被引:55
作者
Gobbini, MI
Smith, ME
Richert, ND
Frank, JA
McFarland, HF
机构
[1] NINDS, Neuroimmunol Branch, NIH, Bethesda, MD 20892 USA
[2] NIH, Lab Diagnost Radiol REs, Off Director, Bethesda, MD 20892 USA
基金
美国国家卫生研究院;
关键词
multiple sclerosis; cyclophosphamide; magnetic resonance; white matter lesion load; gadolinium;
D O I
10.1016/S0165-5728(99)00039-9
中图分类号
R392 [医学免疫学]; Q939.91 [免疫学];
学科分类号
100102 ;
摘要
Objective. To evaluate the response to cyclophosphamide (CTX) of five patients who failed an average three treatments with multiple other therapeutic agents, using serial monthly MRI measures. Methods. Five patients with relapsing-remitting multiple sclerosis (MS) and documented MRT disease activity were started on monthly pulse intravenous CTX at a dose of I g/m(2). CTX was administered without an induction phase according to the protocol similar to the treatment of lupus nephritis. The five patients were followed with monthly MRI and clinical evaluation for a mean of 28 months. Results. All the patients showed a rapid reduction in the contrast-enhancing lesion frequency and in three patients there was a decrease in the T2, lesion load within the first 5 months after starting CTX treatment. The administration of CTX during overnight hospitalization was safe and well tolerated. Conclusions. These findings suggest that aggressive immunosuppressive therapy may be useful in some rapidly deteriorating refractory patients and further controlled study should be considered in order to full evaluate this type of treatment as a potential therapy in MS. (C) 1999 Elsevier Science B.V. All rights reserved.
引用
收藏
页码:142 / 149
页数:8
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