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Treatment of Multiple Sclerosis with Cyclophosphamide

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Treatment of Multiple Sclerosis

Part of the book series: Clinical Medicine and the Nervous System ((CLIN.MED.NERV.))

Abstract

Multiple sclerosis (MS) is an inflammatory disease of the central nervous system of presumed autoimmune etiology. A number of immune abnormalities have been described in the disease including loss of suppressor influences and activated T- and B-cells both in the central nervous system and the periphery (Hafler and Weiner 1989). The majority of immunotherapeutic approaches studied over the past 20 years have been designed to suppress the immune system in MS. This has included attempts at both antigen-specific and antigen non-specific suppression (Weiner and Hafler 1988).

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References

  • Aimard G, Girard PF, Raveau J et al. (1966) Sclerose et plaques et processus d’autoimmunisation. Traitement par les anti-mitotiques. Lyon Med 215: 345–352

    CAS  Google Scholar 

  • Bahr U, Schulten HR, Hommes OR, Aerts F (1980) Determination of cyclophosphamide in urine, serum and cerebrospinal fluid of multiple sclerosis patients by field desorption mass spectrometry. Clin Chim Acta 103: 183–192

    Article  PubMed  CAS  Google Scholar 

  • Balow JE, Austin HA, Tsokos GC, Antonovych TT, Steinberg AD, Klipper JH (1987) Lupus nephritis. Ann Int Med 106: 79–94

    PubMed  CAS  Google Scholar 

  • Brinkman CJJ, Nillesen WM, Hommes OR (1983) T-cell subpopulations blood and cerebrospinal fluid of multiple sclerosis patients: effect of cyclophosphamide. Clin Immun Immunopathol 29: 341–348

    Article  CAS  Google Scholar 

  • Brinkman CJJ, Nillesen WM, Hommes OR (1984) The effect of cyclophosphamide on T lymphocytes and T lymphocyte subsets in patients with chronic progressive multiple sclerosis. Acta Neurol Scand 69: 90–96

    Article  PubMed  CAS  Google Scholar 

  • Carter JL, Hafler DA, Dawson DM, Orav J, Weiner HL (1988) Immunosuppression with high-dose cyclophosphamide and ACTH in progressive multiple sclerosis: Cumulative 6-year experience in 164 patients. Neurology (Suppl 2 ) 38: 9–14

    Google Scholar 

  • Cendrowski W (1973) Combined therapeutic trial in multiple sclerosis: hydrocortisone hemisuc cinate with cyclophosphamide or cytosine arabinoside. Acta Neurol Belg 73: 209–219

    PubMed  CAS  Google Scholar 

  • Drachman DA (1975) Cyclophosphamide in exacerbations of multiple sclerosis: Therapeutic trial and a strategy for pilot drug studies. Neurol Neurosurg Psychiatry 38: 592–597

    Article  CAS  Google Scholar 

  • Fox DA, McCune WJ (1989) Immunologic and clinical effects of cytotoxic drugs used in the treatment of rheumatoid arthritis and systemic lupus erythematosus. Concepts Immunopathol, Basel, Karger 7: 20–78

    Google Scholar 

  • Girard PF, Aimard G, Pellett H (1967) Immunodepressive therapy in neurology. Presse Med 75: 967–968

    PubMed  CAS  Google Scholar 

  • Gonsette RE, Demonty L, Delmotte P (1977) Intensive immunosuppression with cyclophosph- amide in multiple sclerosis. Follow up of 100 patients for 2–6 years. J Neurol 214: 173–181

    Article  PubMed  CAS  Google Scholar 

  • Gonsette RE, Demonty L, Delmotte P (1980) Intensive immunosuppression with cyclophosphamide in remittent forms of multiple sclerosis. A follow-up of 134 patients for 2–10 years. In: Bauer HJ, Poser S, Ritter G (eds) Progress in Multiple Sclerosis Research. Springer-Verlag, Berlin, pp 401–406

    Chapter  Google Scholar 

  • Goodkin DE, Plencner S, Palmer-Saxerud J, Teetzen M, Hertsgaard D (1987) Cyclophosphamide in chronic progressive multiple sclerosis: Maintenance vs. nonmaintenance therapy. Arch Neurol 44: 823–827

    Google Scholar 

  • Hafler DA, Orav J, Gertz R, Stazzone L, Weiner HL (1991) Immunologic effects of cyclophosphamide/ACTH in patients with chronic progressive multiple sclerosis. J Neuroimmunol 32: 149–158

    Article  PubMed  CAS  Google Scholar 

  • Hafler DA, Weiner HL (1989) MS: a CNS and systemic autoimmune disease. Immunol Today 10: 104–107

    Article  PubMed  CAS  Google Scholar 

  • Hauser SL, Dawson DM, Lehrich JR, Beal MF, Kevy SV, Propper RD, Mills JA, Weiner HL (1983) Intensive immunosuppression in progressive multiple sclerosis: A randomized, three-arm study of high-dose cyclophosphamide, plasma exchange, and ACTH. N Engl J Med 308: 173–180

    CAS  Google Scholar 

  • Hommes OR, Prick JJG, Lamers KJB (1975) Treatment of the chronic progressive form of multiple sclerosis with a combination of cyclophosphamide and prednisone. Clin Neurol Neurosurg 78: 59–73

    Article  PubMed  CAS  Google Scholar 

  • Hommes OR, Lamers KJB, Reekers P (1980a) Effect of intensive immunosuppression on the course of chronic progressive multiple sclerosis. J Neurol 223: 177–190

    Article  Google Scholar 

  • Hommes OR, Lamers KJB, Reekers P (1980b) Prognostic factors in intensive immunosuppressive treatment of chronic progressive MS. In: Bauer HJ, Poser S, Ritter G (eds) Progress in Multiple Sclerosis Research. Springer-Verlag, Berlin, pp 396–400

    Chapter  Google Scholar 

  • Kaldor JM, Day NE, Pettersson F et al. (1990) Leukemia following chemotherapy for ovarian cancer. N Engl J Med 322: 1–6

    Article  PubMed  CAS  Google Scholar 

  • Killian JM, Bressler RB, Armstrong RM, Huston DP (1988) Controlled pilot trial of monthly intravenous cyclophosphamide in multiple sclerosis. Arch Neurol 45: 27–30

    PubMed  CAS  Google Scholar 

  • Lamers KJB, Uitdehaag BMJ, Hommes OR, Doesburg W, Wevers RA, Geel WJA (1988) The short-term effect of an immunosuppressive treatment on CSF myelin basic protein in chronic progressive multiple sclerosis. J Neurol Neurosurg Psychiatry 51: 1334–1337

    Article  PubMed  CAS  Google Scholar 

  • Likosky WH (1988) Experience with cyclophosphamide in multiple sclerosis: The cons. Neurology 38 (suppl 2): 14–19

    PubMed  CAS  Google Scholar 

  • Mackin GA, Weiner HL, Orav J et al. (1991) IV cyclophosphamide/ACTH plus maintenance cyclophosphamide boosters in progressive MS: final report of the Northeast Cooperative Treatment Group. Neurology 41 (suppl 1): 147

    Google Scholar 

  • Mauch E, Kornhuber HH, Pfrommer U, Hahnel A, Laufen H, Krapf H (1989) Effective treatment of chronic progressive multiple sclerosis with low-dose cyclophosphamide with minor side-effects. Eur Arch Psychiatr Neurol Sci 238: 115–117

    Article  CAS  Google Scholar 

  • McCune WJ, Golbus J; Zeldes W et al. (1988) Clinical and immunologic effects of monthly administration of intravenous cyclophosphamide in severe systemic lupus erythematosus. N Engl J Med 318: 1423–1431

    Google Scholar 

  • Mickey MR, Ellison GW, Fahey JL, Moody DJ, Myers LW (1987) Correlation of clinical and immunological states in multiple sclerosis. Arch Neurol 44: 371–375

    PubMed  CAS  Google Scholar 

  • Millac M, Miller H (1969) Cyclophosphamide in multiple sclerosis. Lancet 1: 783

    Article  PubMed  CAS  Google Scholar 

  • Moody DJ, Fahey JL, Grable E, Ellison GW, Myers LW (1987) Administration of monthly pulses of cyclophosphamide in multiple sclerosis patients: delayed recovery of several immune parameters following discontinuation of long-term cyclophosphamide treatment. J Neuroimmunol 14: 175–182

    Article  PubMed  CAS  Google Scholar 

  • Moody DJ, Kagan J, Liao D, Ellison GW, Myers LW (1978) Administration of monthly-pulse cyclophosphamide in multiple sclerosis patients: effects of long-term treatment on immunologic parameters. J Neuroimmunol 14: 161–173

    Article  Google Scholar 

  • Myers LW, Fahey JL, Moody DJ, Mickey MR, Frane MV, Ellison GW (1987) Cyclophosphamide “pulses” in chronic progressive multiple sclerosis: Arch Neurol 44: 828–832

    PubMed  CAS  Google Scholar 

  • Noseworthy JH, Vandervoort MK, Wong CJ, Ebers GC, and the Canadian Cooperative MS Group (1990) Interrater variability with the Expanded Disability Status Scale (EDSS) and Functional Systems ( FS) in a multiple sclerosis clinical trial. Neurology 40: 971–975

    Google Scholar 

  • The Canadian Cooperative Multiple Sclerosis Study Group (1991) The Canadian Cooperative trial of cyclophosphamide and plasma exchange in progressive multiple sclerosis. Lancet 337: 442–446

    Google Scholar 

  • The Multiple Sclerosis Study Group (1990) Efficacy and toxicity of cyclosporine in chronic progressive multiple sclerosis: A randomized, double-blinded, placebo-controlled clinical trial. Ann Neurol 27: 591–605

    Article  Google Scholar 

  • Theys P, Gosseye-Lissoir F, Ketelaer P, Carton H (1981) Short-term intensive cyclophosphamide treatment in multiple sclerosis: A retrospective controlled study. J Neurol 225: 119–133

    Article  PubMed  CAS  Google Scholar 

  • Thompson AJ, Kermode AG, MacManus DG (1990) Patterns of disease activity in multiple sclerosis: clinical and magnetic resonance imaging study. Br Med J 300: 631–634

    Article  CAS  Google Scholar 

  • Thompson AJ, Kermode AG, Loicks D (1991) Major differences in the dynamics of primary and secondary progressive multiple sclerosis. Ann Neurol 29: 53–62

    Article  PubMed  CAS  Google Scholar 

  • Uitdehaag BMJ, Nillesen WM, Hommes OR (1989) Long-lasting effects of cyclophosphamide on lymphocytes in peripheral blood and spinal fluid. Acta Neurol Scand 79: 12–17

    Article  PubMed  CAS  Google Scholar 

  • Weiner HL, Hauser SL, Dawson DM, Hafler DA, Mackin GA, Orav EJ (1991) Cyclophosphamide and plasma exchange in multiple sclerosis. Lancet 337: 1033–1034

    Article  Google Scholar 

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Authors
  1. Glenn A. Mackin
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  2. David M. Dawson
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  3. David A. Hafler
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  4. Howard L. Weiner
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Editor information

Editors and Affiliations

  1. Mellen Center for Multiple Sclerosis Treatment and Research, Cleveland Clinic Foundation, 9500 Euclid Avenue, 44195-5244, Cleveland, OH, USA

    Richard A. Rudick MD  & Donald E. Goodkin MD  & 

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© 1992 Springer-Verlag London Limited

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Mackin, G.A., Dawson, D.M., Hafler, D.A., Weiner, H.L. (1992). Treatment of Multiple Sclerosis with Cyclophosphamide. In: Rudick, R.A., Goodkin, D.E. (eds) Treatment of Multiple Sclerosis. Clinical Medicine and the Nervous System. Springer, London. https://doi.org/10.1007/978-1-4471-3184-7_9

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  • DOI: https://doi.org/10.1007/978-1-4471-3184-7_9

  • Publisher Name: Springer, London

  • Print ISBN: 978-1-4471-3186-1

  • Online ISBN: 978-1-4471-3184-7

  • eBook Packages: Springer Book Archive

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