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  • Brain tissue loss occurs after suppression of enhancement in patients with multiple sclerosis treated with autologous haematopoietic stem cell transplantation

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Brain tissue loss occurs after suppression of enhancement in patients with multiple sclerosis treated with autologous haematopoietic stem cell transplantation
  1. M Inglese1,2,
  2. G L Mancardi2,
  3. E Pagani1,
  4. M A Rocca1,
  5. A Murialdo2,
  6. R Saccardi3,
  7. G Comi4,
  8. M Filippi,
  9. the Italian GITMO-NEURO Intergroup on Autologous Hemotopoietic Stem Cell Transplantation*
  1. 1Neuroimaging Research Unit, Department of Neurology, Scientific Institute Ospedale San Raffaele, Milan, Italy
  2. 2Department of Neuroscience, Ophthalmology and Genetics, University of Genoa, Genoa, Italy
  3. 3Bone Marrow Transplantation Unit, Ospedale Careggi, University of Florence, Florence, Italy
  4. 4Department of Neurology, Scientific Institute and University Ospedale San Raffaele, Milan, Italy
  1. Correspondence to:
 Dr M Filippi
 Neuroimaging Research Unit, Department of Neurology, Scientific Institute Ospedale San Raffaele, Via Olgettina 60, 20132 Milan, Italy; filippi.massimohsr.it

Abstract

To assess whether brain tissue loss occurs after profound and sustained suppression of magnetic resonance imaging (MRI) enhancement, we measured brain volume changes from 10 patients with rapidly evolving secondary progressive multiple sclerosis (MS) treated with autologous haematopoietic stem cell transplantation and followed up for 24 months. An average yearly decrease of brain volume of about 1.9% was observed despite only five enhancing lesions seen on triple dose follow up scans of two patients. This indicates that, in MS, progressive loss of tissue can occur independently of concomitant MRI-visible inflammation.

  • multiple sclerosis
  • enhancement
  • brain atrophy
  • autologous stem cell transplantation
  • AHSCT, autologous haematopoietic stem cell transplantation
  • DTPA, diethylenetriamine penta-acetic acid
  • G-CSF, granulocyte-colony stimulating factor
  • Gd, gadolinium
  • MRI, magnetic resonance imaging
  • MS, multiple sclerosis
  • NBV, normalised brain volume
  • PBVC, percentage normalised brain volume change
  • SPMS, secondary progressive multiple sclerosis

https://doi.org/10.1136/jnnp.2003.021865

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    Footnotes

    • ↵* See Appendix for a list of the members of the Italian GITMO-NEURO Intergroup on Autologous Hematopoietic Stem Cell Transplantation.

    • Competing interests: none declared