A Feasibility Study of the Full Outpatient Conduction of Hematopoietic Transplants in Persons with Multiple Sclerosis Employing Autologous Non-Cryopreserved Peripheral Blood Stem Cells

作者：Ruiz Arguelles Guillermo J; Leon Pena Andres A; Leon Gonzalez Monica; Karen Nunez Cortes Ana; Carlos Olivares Gazca Juan; Murrieta Alvarez Ivan; Vargas Espinosa Jocelyn; Medina Ceballos Emilio; Cantero Fortiz Yahveth; Ruiz Arugelles Alejandro; Ruiz Delgado Manuel A; Ruiz Delgado Rodrigo J; Ruiz Reyes Guillermo; Priesca Marin Manuel; Starlight Torres Priego Merari; Blumenkron Marroquin David; Ruiz Delgado Guillermo J

来源：Acta Haematologica, 2017, 137(4): 214-219.

DOI：10.1159/000469655

• Autografts
• Autotransplants
• Multiple sclerosis

Background: With the goal of achieving immune system reset, autologous hematopoietic stem cell transplantations have been performed in patients with multiple sclerosis (MS). Material and Methods: Two hundred and eighty-six consecutive patients with MS were autografted in a single center using non-frozen peripheral blood stem cells (PBSCs), on an outpatient basis and conditioning with cyclophosphamide and rituximab. The protocol was registered in Clinical-Trials. gov identifier NCT02674217. Results: One hundred and ninety-four females and 92 males were included; the median age was 47. All procedures were started on an outpatient basis and only 8 persons needed to be admitted to the hospital during the procedure. In order to obtain at least 1 x 10 6 /kg viable CD34 cells, 1-4 aphereses were performed median 1). The total number of viable CD34+ cells infused ranged between 1 and 19.2 x 10(6) /kg (median 4.6). Patients recovered above 0.5 x 10(9) /L absolute granulocytes on median day 8 (range 0-12). Two individuals needed red blood cells but none needed platelet transfusions. There were no transplant-related deaths and the 128-month overall survival of the patients is 100%. In 82 persons followed up for 3 or more months, the Expanded Disability Status Scale diminished from a mean of 5.2-4.9, the best results being obtained in relapsing-remitting and primary progressive MS. Conclusions: It is possible to conduct autotransplants for patients with MS employing non-frozen PBSCs and outpatient conduction. Additional information is needed to assess the efficacy of these procedures in the treatment of patients with MS.

• 出版日期2017