Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Clinical Trial
. 2007 Oct;28(9):1659-61.
doi: 10.3174/ajnr.A0644. Epub 2007 Sep 20.

A three-year study of brain atrophy after autologous hematopoietic stem cell transplantation in rapidly evolving secondary progressive multiple sclerosis

M A Rocca  1 , T Mondria, P Valsasina, M P Sormani, Z H Flach, P A Te Boekhorst, G Comi, R Q Hintzen, M Filippi
Affiliations
Clinical Trial

A three-year study of brain atrophy after autologous hematopoietic stem cell transplantation in rapidly evolving secondary progressive multiple sclerosis

M A Rocca et al. AJNR Am J Neuroradiol. 2007 Oct.

Abstract

Background and purpose: In multiple sclerosis (MS), autologous hematopoietic stem cell transplantation (AHSCT) induces a profound suppression of clinical activity and MR imaging-detectable inflammation, but it may be associated with a rapid brain volume loss in the months subsequent to treatment. The aim of this study was to assess how AHSCT affects medium-term evolution of brain atrophy in MS.

Materials and methods: MR imaging scans of the brain from 14 patients with rapidly evolving secondary-progressive MS obtained 3 months before and every year after AHSCT for 3 years were analyzed. Baseline normalized brain volumes and longitudinal percentage of brain volume changes (PBVCs) were assessed using the Structural Image Evaluation of Normalized Atrophy software.

Results: The median decrease of brain volume was 1.92% over the first year after AHSCT and then declined to 1.35% at the second year and to 0.69% at the third year. The number of enhancing lesions seen on the pretreatment scans was significantly correlated with the PBVCs between baseline and month 12 (r = -0.62; P = .02); no correlation was found with the PBVCs measured over the second and third years.

Conclusions: After AHSCT, the rate of brain tissue loss in patients with MS declines dramatically after the first 2 years. The initial rapid development of brain atrophy may be a late consequence of the pretransplant disease activity and/or a transient result of the intense immunoablative conditioning procedure.

PubMed Disclaimer

References

    1. Blanco Y, Saiz A, Carreras E, et al. Autologous haematopoietic stem-cell transplantation for multiple sclerosis. Lancet Neurol 2005;4:54–63 - PubMed
    1. Mancardi GL, Saccardi R, Filippi M, et al. Autologous hematopoietic stem cell transplantation suppresses gadolinium-enhanced MRI activity in multiple sclerosis. Neurology 2001;57:62–68 - PubMed
    1. Samijn JPA, Te Boekhorst PAW, Mondria T, et al. Intense T cell depletion followed by autologous bone marrow transplantation for severe multiple sclerosis. J Neurol Neurosurg Psychiatry 2006;77:46–50 - PMC - PubMed
    1. Chen JT, Collins DL, Atkins HL, et al. Brain atrophy after immunoablation and stem cell transplantation in multiple sclerosis. Neurology 2006;66:1935–37 - PubMed
    1. Inglese M, Mancardi GL, Pagani E, et al. Brain tissue loss occurs after suppression of transplantation treated with autologous haematopoietic stem cell enhancement in patients with multiple sclerosis. J Neurol Neurosurg Psychiatry 2004;75:643–44 - PMC - PubMed

Publication types