Immunoablation and Hemopoietic Cell Support in the Treatment of MultipleSclerosis

Overview

High dose chemotherapy with autologous hematopoietic cell support is a standard approach in the managementof selected hematological malignancies. Autoimmune diseases which do not respond to conventional immunosup-pression might benefit from high dose immunoablative chemotherapy. The transplantation of hematopoietic cells isnecessary after the high dose chemotherapy to restore bone marrow function. The immune system undergoes a newontogeny which can result in the development of tolerance. Multiple sclerosis (MS) has so far been the most commonindication for this kind of treatment. Experience with preclinical studies on murine experimental allergic encepha-lomyelitis (EAE), as well as the course of MS following bone marrow transplantation for coincidental malignancyin humans formed the basis of the first clinical studies involving high dose chemotherapy and autologous hemato-poietic support. Results of the first studies confirm that the method is feasible in patients with MS, and that the effectis very promising. Nonetheless, more consistent results vis a vis the therapeutic effect should emanate from upcomingstudies.

Key words:
autologous hemopoietic cell support, hematological malignancies, hig dose chemotherapy, autoim-