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

N. Hamerschlak*, M. Rodrigues, D. A. Moraes, M. C. Oliveira, A. B.P.L. Stracieri, F. Pieroni, G. M.N. Barros, M. I.A. Madeira, B. P. Simes, A. A. Barreira, D. G. Brum, A. A.F. Ribeirão, J. M. Kutner, C. P. Tylberi, P. P. Porto, C. L. Santana, J. Z. Neto, J. C. Barros, A. T. Paes, R. K. BurtE. A. Oliveira, A. P. Mastropietro, A. C. Santos, J. C. Voltarelli

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

48 Scopus citations

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.

Original languageEnglish (US)
Pages (from-to)239-248
Number of pages10
JournalBone Marrow Transplantation
Volume45
Issue number2
DOIs
StatePublished - Feb 2010

Keywords

  • BEAM regimen
  • CY
  • Hematopoietic SCT
  • Hematopoietic stem cell mobilization
  • Multiple sclerosis

ASJC Scopus subject areas

  • Hematology
  • Transplantation

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