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Natalizumab in aggressive multiple sclerosis after haematopoietic stem cell transplantation

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Abstract

High-dose cyclophosphamide followed by autologous haematopoietic stem cell transplantation (HDC-AHSCT) is a treatment option for aggressive and refractory multiple sclerosis (MS). Natalizumab is a monoclonal antibody approved for relapsing-remitting (RR) MS unresponsive to immunomodulating drugs. Nothing is known about the use of natalizumab in patients after HDC-AHSCT. We describe five female RR-MS patients with incomplete response to HDC-AHSCT. Natalizumab was then administered with abolition of both MRI and clinical activity. No severe adverse events, in particular opportunistic infections such as Progressive Multifocal Leukoencephalopathy (PML), were observed. Our results suggest that the use of natalizumab in aggressive RR-MS after HDC-AHSCT could be effective and safe. The very long-term risk of adverse events due to sequential aggressive immunosuppression has to be established.

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Conflict of interest

This study was not sponsored. M. Capobianco received grants from Biogen-Idec, Biogen-Dompè, Sanofi-Aventis, Schering-Bayer, Merck-Serono and Teva. A. Bertolotto has served as a consultant and received research grants from Biogen-Idec, Biogen-Dompè, Sanofi-Aventis, Schering-Bayer, Merck-Serono and Teva. M. G. Marrosu has served as a consultant and received research grants from Biogen-Idec, Biogen-Dompè, Sanofi-Aventis, Schering-Bayer, Merck-Serono and Teva. J. Frau received grants from Biogen-Idec, Biogen-Dompè, Sanofi-Aventis, Schering-Bayer, Merck-Serono and Teva. E. Cocco received grants from Biogen-Idec, Biogen-Dompè, Sanofi-Aventis, Schering-Bayer, Merck-Serono and Teva. E. Mamusa received grants from Biogen-Idec, Biogen-Dompè, Sanofi-Aventis, Schering-Bayer, Merck-Serono and Teva.

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Authors and Affiliations

  1. Department of Neurology 2, Regional Multiple Sclerosis Centre, AOU San Luigi Gonzaga, Regione Gonzole 10, 10043, Orbassano, Italy

    Marco Capobianco & A. Bertolotto

  2. Department of Neurology and Neurosurgery, Belorussian State Medical University, Minsk, Belarus

    Y. Motuzova

  3. Department of Cardiovascular and Neurological Science, Multiple Sclerosis Centre, University of Cagliari, Ospedale Binaghi, Cagliari, Italy

    J. Frau, E. Cocco, E. Mamusa & M. G. Marrosu

Authors
  1. Marco Capobianco
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  2. Y. Motuzova
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  3. J. Frau
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  4. E. Cocco
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  5. E. Mamusa
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  6. M. G. Marrosu
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  7. A. Bertolotto
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Corresponding author

Correspondence to Marco Capobianco.

Additional information

M. Capobianco and Y. Motuzova contributed equally to this work.

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Capobianco, M., Motuzova, Y., Frau, J. et al. Natalizumab in aggressive multiple sclerosis after haematopoietic stem cell transplantation. Neurol Sci 33, 863–867 (2012). https://doi.org/10.1007/s10072-011-0848-1

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  • DOI: https://doi.org/10.1007/s10072-011-0848-1

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