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Conditioning Regimens

Brazilian experience with two conditioning regimens in patients with multiple sclerosis: BEAM/horse ATG and CY/rabbit ATG

Bone Marrow Transplantation volume 45, pages 239–248 (2010)Cite this article

Abstract

Studies have shown that autologous hematopoietic SCT (HSCT) can be used as an intensive immunosuppressive therapy to treat refractory patients and to prevent the progression of multiple sclerosis (MS). This is a prospective multicentric Brazilian MS trial comparing two conditioning regimens: BEAM/horse ATG and CY/rabbit ATG. Most (80.4%) of the 41 subjects in the study had the secondary progressive MS subtype and the mean age was 42 years. The baseline EDSS score in 58.5% of the subjects was 6.5 and 78% had a score of 6.0 or higher, respectively. The complication rate during the intra-transplantation period was 56% for all patients: 71.4% of the patients in the BEAM/hATG group and 40% in the CY/rATG group (P=0.04). Three subjects (7.5%) died of cardiac toxicity, sepsis and alveolar hemorrhage, all of them in the BEAM/ATG group. EFS was 58.54% for all patients: 47% in the BEAM/hATG group and 70% in the CY/rATG group (P=0.288). In conclusion, the CY/rATG regimen seems to be associated with similar outcome results, but presented less toxicity when compared with the BEAM/hATG regimen. Long-term follow-up would be required to fully assess the differences in therapeutic effectiveness between the two regimens.

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Acknowledgements

We thank the research financial agencies for the funding: Fundação de Apoio ao Ensino, Pesquisa e Assistência do Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo (FAEPA-HCRP), Fundação Hemocentro de Ribeirão Preto (FUNDHERP), Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq), Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP) and Financiadora de Estudos e Projetos (FINEP), Instituto Israelita Albert Einstein de Ensino e Pesquisa and Instituto Israelita de Responsabilidade Social Albert Einstein.

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Authors and Affiliations

  1. Bone Marrow Transplant Unit, Hospital Israelita Albert Einstein, São Paulo, Brazil

    N Hamerschlak, M Rodrigues, A A F Ribeiro & J M Kutner

  2. Bone Marrow Transplant Unit, Hospital das Clinicas, Ribeirão Preto School of Medicine, University of São Paulo, São Paulo, Brazil

    D A Moraes, M C Oliveira, A B P L Stracieri, F Pieroni, G M N Barros, M I A Madeira, B P Simões, E A Oliveira, A P Mastropietro & J C Voltarelli

  3. Department of Neurosciences and Behavioral Sciences, Hospital das Clinicas, Ribeirão Preto School of Medicine, University of São Paulo, São Paulo, Brazil

    A A Barreira & D G Brum

  4. Neurology Department, Hospital Israelita Albert Einstein, São Paulo, Brazil

    C P Tylberi & P P Porto

  5. Bone Marrow Transplant Unit, Hospital Araújo Jorge, Goiânia, Brazil

    C L Santana

  6. Bone Marrow Transplant Unit, Hospital das Clinicas de Curitiba, Universidade Federal do Paraná, Curitiba, Brazil

    J Z Neto

  7. Bone Marrow Transplant Unit, Faculdade de Medicina de Santa Casa de São Paulo, São Paulo, Brazil

    J C Barros

  8. Educational and Research Institute, Hospital Israelita Albert Einstein, São Paulo, Brazil

    A T Paes

  9. Division of Immunotherapy, Northwestern University Feinberg School of Medicine, Chicago, IL, USA

    R K Burt

  10. Department of Clinical Medicine, Ribeirão Preto School of Medicine, São Paulo, Brazil

    A C Santos

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Hamerschlak, N., Rodrigues, M., Moraes, D. et al. Brazilian experience with two conditioning regimens in patients with multiple sclerosis: BEAM/horse ATG and CY/rabbit ATG. Bone Marrow Transplant 45, 239–248 (2010). https://doi.org/10.1038/bmt.2009.127

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