Brazilian experience with two conditioning regimens in patients with multiple sclerosis: BEAM/horse ATG and CY/rabbit ATG

Studies have shown that autologous hematopoietic SCT (HSCT) can be used as an intensive immunosuppressive therapy to treat refractory patients and to prevent the progression of multiple sclerosis (MS). This is a prospective multicentric Brazilian MS trial comparing two conditioning regimens: BEAM/ho...

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Published inBone marrow transplantation (Basingstoke) Vol. 45; no. 2; pp. 239 - 248
Main Authors Hamerschlak, N, Rodrigues, M, Moraes, D A, Oliveira, M C, Stracieri, A B P L, Pieroni, F, Barros, G M N, Madeira, M I A, Simões, B P, Barreira, A A, Brum, D G, Ribeiro, A A F, Kutner, J M, Tylberi, C P, Porto, P P, Santana, C L, Neto, J Z, Barros, J C, Paes, A T, Burt, R K, Oliveira, E A, Mastropietro, A P, Santos, A C, Voltarelli, J C
Format Journal Article
LanguageEnglish
Published London Nature Publishing Group UK 01.02.2010
Nature Publishing Group
Subjects
Adult
Alveoli
Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy
Animals
Antilymphocyte Serum - administration & dosage
Antineoplastic Combined Chemotherapy Protocols - administration & dosage
Autografts
Biological and medical sciences
Bone marrow, stem cells transplantation. Graft versus host reaction
Care and treatment
Carmustine - administration & dosage
Cell Biology
Conditioning
Cytarabine - administration & dosage
Development and progression
Etoposide - administration & dosage
Female
Graft Rejection - prevention & control
Hematology
Hematopoietic Stem Cell Mobilization
Hematopoietic Stem Cell Transplantation - methods
Hematopoietic stem cells
Hemorrhage
Horses
Humans
Immunosuppressive agents
Internal Medicine
Male
Medical sciences
Medicine
Medicine & Public Health
Melphalan - administration & dosage
Middle Aged
Multiple sclerosis
Multiple Sclerosis - therapy
Multiple sclerosis and variants. Guillain barré syndrome and other inflammatory polyneuropathies. Leukoencephalitis
Neurology
original-article
Public Health
Quality of Life
Rabbits
Sepsis
Stem cell transplantation
Stem Cells
Toxicity
Transfusions. Complications. Transfusion reactions. Cell and gene therapy
Transplantation
Transplantation Conditioning - methods
South America
Brazil
America
hematopoietic SCT
hematopoietic stem cell mobilization
multiple sclerosis
CY
BEAM regimen
Multiple sclerosis
Stem cell
Hematopoietic cell
Rabbit
Inflammatory disease
Horse
Conditioning
Antithymocyte globulin
Ungulata
Hematopoietic stem cell transplantation
Human
Nervous system diseases
Hematology
Lagomorpha
Mobilization
Vertebrata
Mammalia
Animal
Central nervous system disease
Perissodactyla
Therapeutic protocol
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Abstract Studies have shown that autologous hematopoietic SCT (HSCT) can be used as an intensive immunosuppressive therapy to treat refractory patients and to prevent the progression of multiple sclerosis (MS). This is a prospective multicentric Brazilian MS trial comparing two conditioning regimens: BEAM/horse ATG and CY/rabbit ATG. Most (80.4%) of the 41 subjects in the study had the secondary progressive MS subtype and the mean age was 42 years. The baseline EDSS score in 58.5% of the subjects was 6.5 and 78% had a score of 6.0 or higher, respectively. The complication rate during the intra-transplantation period was 56% for all patients: 71.4% of the patients in the BEAM/hATG group and 40% in the CY/rATG group ( P =0.04). Three subjects (7.5%) died of cardiac toxicity, sepsis and alveolar hemorrhage, all of them in the BEAM/ATG group. EFS was 58.54% for all patients: 47% in the BEAM/hATG group and 70% in the CY/rATG group ( P =0.288). In conclusion, the CY/rATG regimen seems to be associated with similar outcome results, but presented less toxicity when compared with the BEAM/hATG regimen. Long-term follow-up would be required to fully assess the differences in therapeutic effectiveness between the two regimens.
AbstractList Studies have shown that autologous hematopoietic SCT (HSCT) can be used as an intensive immunosuppressive therapy to treat refractory patients and to prevent the progression of multiple sclerosis (MS). This is a prospective multicentric Brazilian MS trial comparing two conditioning regimens: BEAM/horse ATG and CY/ rabbit ATG. Most (80.4%) of the 41 subjects in the study had the secondary progressive MS subtype and the mean age was 42 years. The baseline EDSS score in 58.5% of the subjects was 6.5 and 78% had a score of 6.0 or higher, respectively. The complication rate during the intratransplantation period was 56% for all patients: 71.4% of the patients in the BEAM/hATG group and 40% in the CY/rATG group (P = 0.04). Three subjects (7.5%) died of cardiac toxicity, sepsis and alveolar hemorrhage, all of them in the BEAM/ATG group. EFS was 58.54% for a 11 patients: 47% in the BEAM/hATG group and 70% in the CY/rATG group (P = 0.288). In conclusion, the CY/rATG regimen seems to be associated with similar outcome results, but presented less toxicity when compared with the BEAM/hATG regimen. Long-term follow-up would be required to fully assess the differences in therapeutic effectiveness between the two regimens. Bone Marrow Transplantation (2010) 45, 239-248; doi: 10.1038/bmt.2009.127; published online 6 July 2009 Keywords: hematopoietic SCT; hematopoietic stem cell mobilization; multiple sclerosis; CY; BEAM regimen
Studies have shown that autologous hematopoietic SCT (HSCT) can be used as an intensive immunosuppressive therapy to treat refractory patients and to prevent the progression of multiple sclerosis (MS). This is a prospective multicentric Brazilian MS trial comparing two conditioning regimens: BEAM/horse ATG and CY/rabbit ATG. Most (80.4%) of the 41 subjects in the study had the secondary progressive MS subtype and the mean age was 42 years. The baseline EDSS score in 58.5% of the subjects was 6.5 and 78% had a score of 6.0 or higher, respectively. The complication rate during the intra-transplantation period was 56% for all patients: 71.4% of the patients in the BEAM/hATG group and 40% in the CY/rATG group ( P =0.04). Three subjects (7.5%) died of cardiac toxicity, sepsis and alveolar hemorrhage, all of them in the BEAM/ATG group. EFS was 58.54% for all patients: 47% in the BEAM/hATG group and 70% in the CY/rATG group ( P =0.288). In conclusion, the CY/rATG regimen seems to be associated with similar outcome results, but presented less toxicity when compared with the BEAM/hATG regimen. Long-term follow-up would be required to fully assess the differences in therapeutic effectiveness between the two regimens.
Studies have shown that autologous hematopoietic SCT (HSCT) can be used as an intensive immunosuppressive therapy to treat refractory patients and to prevent the progression of multiple sclerosis (MS). This is a prospective multicentric Brazilian MS trial comparing two conditioning regimens: BEAM/horse ATG and CY/ rabbit ATG. Most (80.4%) of the 41 subjects in the study had the secondary progressive MS subtype and the mean age was 42 years. The baseline EDSS score in 58.5% of the subjects was 6.5 and 78% had a score of 6.0 or higher, respectively. The complication rate during the intratransplantation period was 56% for all patients: 71.4% of the patients in the BEAM/hATG group and 40% in the CY/rATG group (P = 0.04). Three subjects (7.5%) died of cardiac toxicity, sepsis and alveolar hemorrhage, all of them in the BEAM/ATG group. EFS was 58.54% for a 11 patients: 47% in the BEAM/hATG group and 70% in the CY/rATG group (P = 0.288). In conclusion, the CY/rATG regimen seems to be associated with similar outcome results, but presented less toxicity when compared with the BEAM/hATG regimen. Long-term follow-up would be required to fully assess the differences in therapeutic effectiveness between the two regimens.
Studies have shown that autologous hematopoietic SCT (HSCT) can be used as an intensive immunosuppressive therapy to treat refractory patients and to prevent the progression of multiple sclerosis (MS). This is a prospective multicentric Brazilian MS trial comparing two conditioning regimens: BEAM/horse ATG and CY/rabbit ATG. Most (80.4%) of the 41 subjects in the study had the secondary progressive MS subtype and the mean age was 42 years. The baseline EDSS score in 58.5% of the subjects was 6.5 and 78% had a score of 6.0 or higher, respectively. The complication rate during the intra-transplantation period was 56% for all patients: 71.4% of the patients in the BEAM/hATG group and 40% in the CY/rATG group (P=0.04). Three subjects (7.5%) died of cardiac toxicity, sepsis and alveolar hemorrhage, all of them in the BEAM/ATG group. EFS was 58.54% for all patients: 47% in the BEAM/hATG group and 70% in the CY/rATG group (P=0.288). In conclusion, the CY/rATG regimen seems to be associated with similar outcome results, but presented less toxicity when compared with the BEAM/hATG regimen. Long-term follow-up would be required to fully assess the differences in therapeutic effectiveness between the two regimens.
Studies have shown that autologous hematopoietic SCT (HSCT) can be used as an intensive immunosuppressive therapy to treat refractory patients and to prevent the progression of multiple sclerosis (MS). This is a prospective multicentric Brazilian MS trial comparing two conditioning regimens: BEAM/horse ATG and CY/rabbit ATG. Most (80.4%) of the 41 subjects in the study had the secondary progressive MS subtype and the mean age was 42 years. The baseline EDSS score in 58.5% of the subjects was 6.5 and 78% had a score of 6.0 or higher, respectively. The complication rate during the intra-transplantation period was 56% for all patients: 71.4% of the patients in the BEAM/hATG group and 40% in the CY/rATG group (P=0.04). Three subjects (7.5%) died of cardiac toxicity, sepsis and alveolar hemorrhage, all of them in the BEAM/ATG group. EFS was 58.54% for all patients: 47% in the BEAM/hATG group and 70% in the CY/rATG group (P=0.288). In conclusion, the CY/rATG regimen seems to be associated with similar outcome results, but presented less toxicity when compared with the BEAM/hATG regimen. Long-term follow-up would be required to fully assess the differences in therapeutic effectiveness between the two regimens.Studies have shown that autologous hematopoietic SCT (HSCT) can be used as an intensive immunosuppressive therapy to treat refractory patients and to prevent the progression of multiple sclerosis (MS). This is a prospective multicentric Brazilian MS trial comparing two conditioning regimens: BEAM/horse ATG and CY/rabbit ATG. Most (80.4%) of the 41 subjects in the study had the secondary progressive MS subtype and the mean age was 42 years. The baseline EDSS score in 58.5% of the subjects was 6.5 and 78% had a score of 6.0 or higher, respectively. The complication rate during the intra-transplantation period was 56% for all patients: 71.4% of the patients in the BEAM/hATG group and 40% in the CY/rATG group (P=0.04). Three subjects (7.5%) died of cardiac toxicity, sepsis and alveolar hemorrhage, all of them in the BEAM/ATG group. EFS was 58.54% for all patients: 47% in the BEAM/hATG group and 70% in the CY/rATG group (P=0.288). In conclusion, the CY/rATG regimen seems to be associated with similar outcome results, but presented less toxicity when compared with the BEAM/hATG regimen. Long-term follow-up would be required to fully assess the differences in therapeutic effectiveness between the two regimens.
Audience Academic
Author Porto, P P
Barros, J C
Paes, A T
Pieroni, F
Simões, B P
Tylberi, C P
Mastropietro, A P
Moraes, D A
Santana, C L
Voltarelli, J C
Santos, A C
Brum, D G
Stracieri, A B P L
Oliveira, M C
Neto, J Z
Burt, R K
Barros, G M N
Ribeiro, A A F
Barreira, A A
Kutner, J M
Hamerschlak, N
Rodrigues, M
Oliveira, E A
Madeira, M I A
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ContentType Journal Article
Copyright Macmillan Publishers Limited 2010
2015 INIST-CNRS
COPYRIGHT 2010 Nature Publishing Group
Copyright Nature Publishing Group Feb 2010
Macmillan Publishers Limited 2010.
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– notice: 2015 INIST-CNRS
– notice: COPYRIGHT 2010 Nature Publishing Group
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IsPeerReviewed true
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Issue 2
Keywords hematopoietic SCT
hematopoietic stem cell mobilization
multiple sclerosis
CY
BEAM regimen
Multiple sclerosis
Stem cell
Hematopoietic cell
Rabbit
Inflammatory disease
Horse
Conditioning
Antithymocyte globulin
Ungulata
Hematopoietic stem cell transplantation
Human
Nervous system diseases
Hematology
Lagomorpha
Mobilization
Vertebrata
Mammalia
Animal
Central nervous system disease
Perissodactyla
Therapeutic protocol
Language English
License CC BY 4.0
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PublicationSubtitle Official journal of the European Society for Blood and Marrow Transplantation
PublicationTitle Bone marrow transplantation (Basingstoke)
PublicationTitleAbbrev Bone Marrow Transplant
PublicationTitleAlternate Bone Marrow Transplant
PublicationYear 2010
Publisher Nature Publishing Group UK
Nature Publishing Group
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Snippet Studies have shown that autologous hematopoietic SCT (HSCT) can be used as an intensive immunosuppressive therapy to treat refractory patients and to prevent...
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StartPage 239
SubjectTerms Adult
Alveoli
Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy
Animals
Antilymphocyte Serum - administration & dosage
Antineoplastic Combined Chemotherapy Protocols - administration & dosage
Autografts
Biological and medical sciences
Bone marrow, stem cells transplantation. Graft versus host reaction
Care and treatment
Carmustine - administration & dosage
Cell Biology
Conditioning
Cytarabine - administration & dosage
Development and progression
Etoposide - administration & dosage
Female
Graft Rejection - prevention & control
Hematology
Hematopoietic Stem Cell Mobilization
Hematopoietic Stem Cell Transplantation - methods
Hematopoietic stem cells
Hemorrhage
Horses
Humans
Immunosuppressive agents
Internal Medicine
Male
Medical sciences
Medicine
Medicine & Public Health
Melphalan - administration & dosage
Middle Aged
Multiple sclerosis
Multiple Sclerosis - therapy
Multiple sclerosis and variants. Guillain barré syndrome and other inflammatory polyneuropathies. Leukoencephalitis
Neurology
original-article
Public Health
Quality of Life
Rabbits
Sepsis
Stem cell transplantation
Stem Cells
Toxicity
Transfusions. Complications. Transfusion reactions. Cell and gene therapy
Transplantation
Transplantation Conditioning - methods
Title Brazilian experience with two conditioning regimens in patients with multiple sclerosis: BEAM/horse ATG and CY/rabbit ATG
URI https://link.springer.com/article/10.1038/bmt.2009.127
https://www.ncbi.nlm.nih.gov/pubmed/19584827
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Volume 45
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