• Online Features  This Article  • Full text  • PDF  • Reply to article  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Citing articles on Web of Science (4)  • Contact me when this article is cited  Related Content  • Similar articles in this journal  Topic Collections  • Neurology  • Multiple Sclerosis/ Demyelinating Disease  • Transplantation  • Transplantation, Other  • Immunologic Disorders  • Alert me on articles by topic  Social Bookmarking   What's this?

Jian-Qiang Lu, MD, PhD; Jan Storek, MD, PhD; Luanne Metz, MD; V. Wee Yong, PhD; Anne M. Stevens, MD, PhD; Richard A. Nash, MD; Jeffrey T. Joseph, MD, PhD

Arch Neurol. 2009;66(1):116-120.

Objective  To examine the effect of allogeneic hematopoietic cell transplantation (HCT) on disease activity in a patient with multiple sclerosis (MS).

Design  Case report, prospective study, and autopsy.

Setting  Departments of Clinical Neurosciences, Internal Medicine, and Pathology at the University of Calgary, Alberta, Canada.

Patient  A 39-year-old woman with chronic myelogenous leukemia and concurrent mild MS.

Interventions  Hematopoietic cell transplantation from a healthy unrelated donor.

Results  After HCT the patient developed graft-vs-host disease and experienced worsening, but not new, neurological symptoms. Her circulating leukocytes were 100% of donor origin. Magnetic resonance imaging showed increased lesion burden. She died of adenovirus hepatitis 20 weeks after HCT. An autopsy revealed demyelinating-inflammatory activity in active lesions and chronic active lesions.

Conclusion  Despite high-dose, cytotoxic, immunosuppressive therapy and exchange of a presumed autoreactive immune system with a healthy immune system, MS in this patient continued to be active.

Author Affiliations: Departments of Pathology (Drs Lu and Joseph), Internal Medicine (Dr Storek), and Clinical Neurosciences (Drs Metz and Yong), University of Calgary, Alberta, Canada; Department of Pediatrics, University of Washington and Center for Immunity and Immunotherapy, Children's Hospital Research Institute (Dr Stevens); and Fred Hutchinson Cancer Research Center, Seattle, Washington (Dr Nash).

CiteULike    Connotea    Delicious    Digg    Facebook    Reddit    Technorati    Twitter     What's this?

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Neuroinflammation and Demyelination in Multiple Sclerosis After Allogeneic Hematopoietic Stem Cell Transplantation
Lu et al.
Arch Neurol 2010;67:716-722.
ABSTRACT | FULL TEXT