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首页> 外文期刊>Journal of neurology >Autologous hematopoietic stem cell transplantation following pulsed cyclophosphamide in a severely disabled patient with malignant multiple sclerosis.
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Autologous hematopoietic stem cell transplantation following pulsed cyclophosphamide in a severely disabled patient with malignant multiple sclerosis.

机译：严重残疾的恶性多发性硬化患者中，脉冲环磷酰胺后自体造血干细胞移植。

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摘要

Multiple sclerosis (MS) may run a rapidly progressive monophasic course (the Marburg, or malignant form), that carries a poor prognosis [1]. Autologous hematopoietic stem cell transplant (AHSCT), initially utilised in chronic MS [2], is now occasionally administered in acute aggressive relapsing-remitting MS (RRMS) [3]. We describe a case of malignant-type MS treated with pulsed cyclophosphamide (CY) and non-myeloablative AHSCT. A 21-year-old woman, presented with sensorimotor disturbance to all four limbs in April 2011. Neuro-imaging demonstrated demyelination with enhancement (Fig. la), cerebrospinal fluid (CSF) demonstrated 47 lymphocytes and was positive for oligoclonal bands. Serum was negative for aquporin4 (Aq4) antibodies. Three days of 1 g IV methylprednisolone (IVMP) failed to slow progression. A second course of IVMP 5 weeks later was unsuccessful, as were seven sessions of plasma exchange undertaken over a 2-week period and the patient became tetraplegic.
机译：多发性硬化症（MS）可能会进行快速进展的单相病程（马尔堡或恶性形式），预后较差[1]。自体造血干细胞移植（AHSCT），最初用于慢性MS [2]，现在偶尔用于急性侵袭性复发-缓解MS（RRMS）[3]。我们描述了一例用脉冲环磷酰胺（CY）和非清髓性AHSCT治疗的恶性型MS。一名21岁妇女于2011年4月对所有四个肢体表现出感觉运动障碍。神经影像检查显示脱髓鞘增强（图1a），脑脊液（CSF）显示47个淋巴细胞，寡克隆带阳性。血清对aquporin4（Aq4）抗体阴性。 3天的1 g静脉注射甲基强的松龙（IVMP）未能减缓病情。 5周后第二次IVMP疗程未成功，在两周内进行了七次血浆置换，患者变为四瘫。

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