Journal article
Lymphocyte reconstitution following autologous stem cell transplantation for progressive MS
Multiple Sclerosis Journal – Experimental, Translational and Clinical, Vol.3(1), pp.1-9
2017
Abstract
BACKGROUND:
Autologous stem cell transplantation (ASCT) for progressive multiple sclerosis (MS) may reset the immune repertoire.
OBJECTIVE:
The objective of this paper is to analyse lymphocyte recovery in patients with progressive MS treated with ASCT.
METHODS:
Patients with progressive MS not responding to conventional treatment underwent ASCT following conditioning with high-dose cyclophosphamide and antithymocyte globulin. Lymphocyte subset analysis was performed before ASCT and for two years following ASCT. Neurological function was assessed by the EDSS before ASCT and for three years post-ASCT.
RESULTS:
CD4+ T-cells fell significantly post-transplant and did not return to baseline levels. Recent thymic emigrants and naïve T-cells fell sharply post-transplant but returned to baseline by nine months and twelve months, respectively. T-regulatory cells declined post-transplant and did not return to baseline levels. Th1 and Th2 cells did not change significantly while Th17 cells fell post-transplant but recovered to baseline by six months. Neurological function remained stable in the majority of patients. Progression-free survival was 69% at three years.
CONCLUSION:
This study demonstrates major changes in the composition of lymphocyte subsets following ASCT for progressive MS. In particular, ablation and subsequent recovery of thymic output is consistent with the concept that ASCT can reset the immune repertoire in MS patients.
Details
- Title
- Lymphocyte reconstitution following autologous stem cell transplantation for progressive MS
- Authors/Creators
- G. Cull (Author/Creator) - Sir Charles Gairdner HospitalD. Hall (Author/Creator) - Sir Charles Gairdner HospitalM.J. Fabis-Pedrini (Author/Creator) - Sir Charles Gairdner HospitalW.M. Carroll (Author/Creator) - Sir Charles Gairdner HospitalL. Forster (Author/Creator) - Pathwest Laboratory MedicineF. Robins (Author/Creator) - Pathwest Laboratory MedicineR. Ghassemifar (Author/Creator) - The University of Western AustraliaC. Crosbie (Author/Creator)S. Walters (Author/Creator) - Sir Charles Gairdner HospitalI. James (Author/Creator) - Murdoch UniversityB. Augustson (Author/Creator) - Sir Charles Gairdner HospitalA.G. Kermode (Author/Creator) - Sir Charles Gairdner Hospital
- Publication Details
- Multiple Sclerosis Journal – Experimental, Translational and Clinical, Vol.3(1), pp.1-9
- Publisher
- SAGE Publications
- Identifiers
- 991005540227307891
- Copyright
- 2017 The Author(s)
- Murdoch Affiliation
- Institute for Immunology and Infectious Diseases
- Language
- English
- Resource Type
- Journal article
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