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Erschienen in: InFo Neurologie + Psychiatrie 10/2022

21.10.2022 | Stammzell-Transplantation | Zertifizierte Fortbildung Neurologie

Reboot des Immunsystems

Stammzelltransplantation bei Multipler Sklerose - wo stehen wir?

verfasst von: Prof. Dr. med. Christoph Heesen, Dr. med. Dr. rer. biol. hum. Max Kaufmann, Dr. med. Dietlinde Janson, Dr. med. Vivien Häußler, Prof. Dr. med. Nicolaus Kröger, Prof. Dr. med. Manuel A. Friese

Erschienen in: InFo Neurologie + Psychiatrie | Ausgabe 10/2022

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Die autologe hämatopoetische Stammzelltransplantation wird seit Mitte der 1990er-Jahre als Behandlungsmöglichkeit bei Multipler Sklerose klinisch untersucht und inzwischen in einigen spezialisierten Zentren auch in der Versorgung außerhalb von Studien eingesetzt. Sie ist eine wertvolle Therapie für aggressive Verläufe der Multiplen Sklerose, insbesondere bei Versagen hochwirksamer Therapien bei persistierenden Schüben und MRT-Aktivität.
Literatur
1.
Zurück zum Zitat Kappos L et al. Contribution of relapse-independent progression vs relapse-associated worsening to overall confirmed disability accumulation in typical relapsing multiple sclerosis in a pooled analysis of 2 randomized clinical trials. JAMA Neurol. 2020;77(9):1132-40 Kappos L et al. Contribution of relapse-independent progression vs relapse-associated worsening to overall confirmed disability accumulation in typical relapsing multiple sclerosis in a pooled analysis of 2 randomized clinical trials. JAMA Neurol. 2020;77(9):1132-40
2.
Zurück zum Zitat Wolinsky JS et al. Long-term follow-up from the ORATORIO trial of ocrelizumab for primary progressive multiple sclerosis: a post-hoc analysis from the ongoing open-label extension of the randomised, placebo-controlled, phase 3 trial. Lancet Neurol. 2020;19(12):998-1009 Wolinsky JS et al. Long-term follow-up from the ORATORIO trial of ocrelizumab for primary progressive multiple sclerosis: a post-hoc analysis from the ongoing open-label extension of the randomised, placebo-controlled, phase 3 trial. Lancet Neurol. 2020;19(12):998-1009
3.
Zurück zum Zitat Willison AG et al. The current standing of autologous haematopoietic stem cell transplantation for the treatment of multiple sclerosis. J Neurol. 2022;269(7):3937-58 Willison AG et al. The current standing of autologous haematopoietic stem cell transplantation for the treatment of multiple sclerosis. J Neurol. 2022;269(7):3937-58
4.
Zurück zum Zitat Snowden JA et al. Indications for haematopoietic cell transplantation for haematological diseases, solid tumours and immune disorders: current practice in Europe, 2022. Bone Marrow Transplant. 2022 Snowden JA et al. Indications for haematopoietic cell transplantation for haematological diseases, solid tumours and immune disorders: current practice in Europe, 2022. Bone Marrow Transplant. 2022
5.
Zurück zum Zitat Hemmer B et al. Diagnose und Therapie der Multiplen Sklerose, Neuromyelitis-optica-Spektrum-Erkrankungen und MOG-IgG-assoziierten Erkrankungen: Deutsche Gesellschaft für Neurologie; 2021 (www.dgn.org/leitlinien) Hemmer B et al. Diagnose und Therapie der Multiplen Sklerose, Neuromyelitis-optica-Spektrum-Erkrankungen und MOG-IgG-assoziierten Erkrankungen: Deutsche Gesellschaft für Neurologie; 2021 (www.dgn.org/leitlinien)
6.
Zurück zum Zitat Muraro PA et al. Autologous haematopoietic stem cell transplantation for treatment of multiple sclerosis. Nat Rev Neurol. 2017;13(7):391-405 Muraro PA et al. Autologous haematopoietic stem cell transplantation for treatment of multiple sclerosis. Nat Rev Neurol. 2017;13(7):391-405
7.
Zurück zum Zitat Miller AE et al. Autologous hematopoietic stem cell transplant in multiple sclerosis: recommendations of the National Multiple Sclerosis Society. JAMA Neurol. 2021;78(2):241-6 Miller AE et al. Autologous hematopoietic stem cell transplant in multiple sclerosis: recommendations of the National Multiple Sclerosis Society. JAMA Neurol. 2021;78(2):241-6
8.
Zurück zum Zitat Sharrack B et al. Autologous haematopoietic stem cell transplantation and other cellular therapy in multiple sclerosis and immune-mediated neurological diseases: updated guidelines and recommendations from the EBMT ADWP and the JACIE EBMT and ISCT. Bone Marrow Transplant. 2020;55(2):283-306 Sharrack B et al. Autologous haematopoietic stem cell transplantation and other cellular therapy in multiple sclerosis and immune-mediated neurological diseases: updated guidelines and recommendations from the EBMT ADWP and the JACIE EBMT and ISCT. Bone Marrow Transplant. 2020;55(2):283-306
9.
Zurück zum Zitat Menon S et al. Characterising aggressive multiple sclerosis. J Neurol Neurosurg Psychiatry. 2013;84(11):1192-8 Menon S et al. Characterising aggressive multiple sclerosis. J Neurol Neurosurg Psychiatry. 2013;84(11):1192-8
10.
Zurück zum Zitat Attfield KE et al. The immunology of multiple sclerosis. Nat Rev Immunol. 2022 May 4. doi: 10.1038/s41577-022-00718-z. Attfield KE et al. The immunology of multiple sclerosis. Nat Rev Immunol. 2022 May 4. doi: 10.1038/s41577-022-00718-z.
11.
Zurück zum Zitat Lanz TV et al. Clonally expanded B cells in multiple sclerosis bind EBV EBNA1 and GlialCAM. Nature. 2022;603(7900):321-7 Lanz TV et al. Clonally expanded B cells in multiple sclerosis bind EBV EBNA1 and GlialCAM. Nature. 2022;603(7900):321-7
12.
Zurück zum Zitat Bjornevik K et al. Longitudinal analysis reveals high prevalence of Epstein-Barr virus associated with multiple sclerosis. Science. 2022;375(6578):296-301 Bjornevik K et al. Longitudinal analysis reveals high prevalence of Epstein-Barr virus associated with multiple sclerosis. Science. 2022;375(6578):296-301
13.
Zurück zum Zitat Olsson T, Barcellos LF, Alfredsson L. Interactions between genetic, lifestyle and environmental risk factors for multiple sclerosis. Nat Rev Neurol. 2017;13(1):25-36 Olsson T, Barcellos LF, Alfredsson L. Interactions between genetic, lifestyle and environmental risk factors for multiple sclerosis. Nat Rev Neurol. 2017;13(1):25-36
14.
Zurück zum Zitat Cencioni MT et al. Immune reconstitution following autologous hematopoietic stem cell transplantation for multiple sclerosis: a review on behalf of the EBMT autoimmune diseases working party. Front Immunol. 2021;12:813957 Cencioni MT et al. Immune reconstitution following autologous hematopoietic stem cell transplantation for multiple sclerosis: a review on behalf of the EBMT autoimmune diseases working party. Front Immunol. 2021;12:813957
15.
Zurück zum Zitat Burt RK et al. Effect of nonmyeloablative hematopoietic stem cell transplantation vs continued disease-modifying therapy on disease progression in patients with relapsing-remitting multiple sclerosis: a randomized clinical trial. JAMA. 2019;321(2):165-74 Burt RK et al. Effect of nonmyeloablative hematopoietic stem cell transplantation vs continued disease-modifying therapy on disease progression in patients with relapsing-remitting multiple sclerosis: a randomized clinical trial. JAMA. 2019;321(2):165-74
16.
Zurück zum Zitat Zhang P, Liu B. Effect of autologous hematopoietic stem cell transplantation on multiple sclerosis and neuromyelitis optica spectrum disorder: a PRISMA-compliant meta-analysis. Bone Marrow Transplant. 2020;55(10):1928-34 Zhang P, Liu B. Effect of autologous hematopoietic stem cell transplantation on multiple sclerosis and neuromyelitis optica spectrum disorder: a PRISMA-compliant meta-analysis. Bone Marrow Transplant. 2020;55(10):1928-34
17.
Zurück zum Zitat Sormani MP et al. Autologous hematopoietic stem cell transplantation in multiple sclerosis: a meta-analysis. Neurology. 2017;88(22):2115-22 Sormani MP et al. Autologous hematopoietic stem cell transplantation in multiple sclerosis: a meta-analysis. Neurology. 2017;88(22):2115-22
18.
Zurück zum Zitat Bose G et al. Autologous hematopoietic stem cell transplantation for multiple sclerosis: A current perspective. Mult Scler. 2021;27(2):167-73 Bose G et al. Autologous hematopoietic stem cell transplantation for multiple sclerosis: A current perspective. Mult Scler. 2021;27(2):167-73
19.
Zurück zum Zitat Atkins HL et al. Immunoablation and autologous haemopoietic stem-cell transplantation for aggressive multiple sclerosis: a multicentre single-group phase 2 trial. Lancet. 2016;388(10044):576-85 Atkins HL et al. Immunoablation and autologous haemopoietic stem-cell transplantation for aggressive multiple sclerosis: a multicentre single-group phase 2 trial. Lancet. 2016;388(10044):576-85
20.
Zurück zum Zitat Nash RA et al. High-dose immunosuppressive therapy and autologous HCT for relapsing-remitting MS. Neurology. 2017;88(9):842-52 Nash RA et al. High-dose immunosuppressive therapy and autologous HCT for relapsing-remitting MS. Neurology. 2017;88(9):842-52
21.
Zurück zum Zitat Casanova B et al. Autologous hematopoietic stem cell transplantation in relapsing-remitting multiple sclerosis: comparison with secondary progressive multiple sclerosis. Neurol Sci. 2017;38(7):1213-21 Casanova B et al. Autologous hematopoietic stem cell transplantation in relapsing-remitting multiple sclerosis: comparison with secondary progressive multiple sclerosis. Neurol Sci. 2017;38(7):1213-21
22.
Zurück zum Zitat Alping P et al. Safety of Alemtuzumab and autologous hematopoietic stem cell transplantation compared to noninduction therapies for multiple sclerosis. Neurology. 2021;96(11):e1574-e84 Alping P et al. Safety of Alemtuzumab and autologous hematopoietic stem cell transplantation compared to noninduction therapies for multiple sclerosis. Neurology. 2021;96(11):e1574-e84
23.
Zurück zum Zitat Zhukovsky C et al. Autologous haematopoietic stem cell transplantation compared with alemtuzumab for relapsing-remitting multiple sclerosis: an observational study. J Neurol Neurosurg Psychiatry. 2021;92(2):189-94 Zhukovsky C et al. Autologous haematopoietic stem cell transplantation compared with alemtuzumab for relapsing-remitting multiple sclerosis: an observational study. J Neurol Neurosurg Psychiatry. 2021;92(2):189-94
24.
Zurück zum Zitat Boffa G et al. Long-Term clinical outcomes of hematopoietic stem cell transplantation in multiple sclerosis. Neurology. 2021 Jan 20; doi: 10.1212/WNL.0000000000011461 Boffa G et al. Long-Term clinical outcomes of hematopoietic stem cell transplantation in multiple sclerosis. Neurology. 2021 Jan 20; doi: 10.1212/WNL.0000000000011461
25.
Zurück zum Zitat Burt RK et al. Real-world application of autologous hematopoietic stem cell transplantation in 507 patients with multiple sclerosis. J Neurol. 2022;269(5):2513-26 Burt RK et al. Real-world application of autologous hematopoietic stem cell transplantation in 507 patients with multiple sclerosis. J Neurol. 2022;269(5):2513-26
26.
Zurück zum Zitat Häußler V et al. aHSCT is superior to alemtuzumab in maintaining NEDA and improving cognition in multiple sclerosis. Ann Clin Transl Neurol. 2021;8(6):1269-78 Häußler V et al. aHSCT is superior to alemtuzumab in maintaining NEDA and improving cognition in multiple sclerosis. Ann Clin Transl Neurol. 2021;8(6):1269-78
27.
Zurück zum Zitat Muraro PA et al. Long-term Outcomes After Autologous Hematopoietic Stem Cell Transplantation for Multiple Sclerosis. JAMA Neurol. 2017;74(4):459-69 Muraro PA et al. Long-term Outcomes After Autologous Hematopoietic Stem Cell Transplantation for Multiple Sclerosis. JAMA Neurol. 2017;74(4):459-69
28.
Zurück zum Zitat Mariottini A et al. Autologous haematopoietic stem cell transplantation versus low-dose immunosuppression in secondary-progressive multiple sclerosis. Eur J Neurol. 2022;29(6):1708-18 Mariottini A et al. Autologous haematopoietic stem cell transplantation versus low-dose immunosuppression in secondary-progressive multiple sclerosis. Eur J Neurol. 2022;29(6):1708-18
29.
Zurück zum Zitat Mariottini A. HSCT outcome in progressive MS: is there evidence of benefit and acceptable risk? ECTRIMS focused workshop, Online 10.-11.3.2022 Mariottini A. HSCT outcome in progressive MS: is there evidence of benefit and acceptable risk? ECTRIMS focused workshop, Online 10.-11.3.2022
30.
Zurück zum Zitat Das J et al. Autologous haematopoietic stem cell transplantation as a first-line disease-modifying therapy in patients with 'aggressive' multiple sclerosis. Mult Scler. 2021;27(8):1198-204 Das J et al. Autologous haematopoietic stem cell transplantation as a first-line disease-modifying therapy in patients with 'aggressive' multiple sclerosis. Mult Scler. 2021;27(8):1198-204
31.
Zurück zum Zitat Nicholas RS et al. Autologous hematopoietic stem cell transplantation in active multiple sclerosis: a real-world case series. Neurology. 2021;97(9):e890-e901 Nicholas RS et al. Autologous hematopoietic stem cell transplantation in active multiple sclerosis: a real-world case series. Neurology. 2021;97(9):e890-e901
32.
Zurück zum Zitat Chatterton S et al. Pregnancy post autologous stem cell transplant with BEAM conditioning for multiple sclerosis. Mult Scler. 2021;27(13):2112-5 Chatterton S et al. Pregnancy post autologous stem cell transplant with BEAM conditioning for multiple sclerosis. Mult Scler. 2021;27(13):2112-5
33.
Zurück zum Zitat Kobelt G et al. New insights into the burden and costs of multiple sclerosis in Europe. Mult Scler. 2017;23(8):1123-36 Kobelt G et al. New insights into the burden and costs of multiple sclerosis in Europe. Mult Scler. 2017;23(8):1123-36
34.
Zurück zum Zitat Tappenden P et al. Autologous haematopoietic stem cell transplantation for secondary progressive multiple sclerosis: an exploratory cost-effectiveness analysis. Bone Marrow Transplant. 2010;45(6):1014-21 Tappenden P et al. Autologous haematopoietic stem cell transplantation for secondary progressive multiple sclerosis: an exploratory cost-effectiveness analysis. Bone Marrow Transplant. 2010;45(6):1014-21
Metadaten
Titel
Reboot des Immunsystems
Stammzelltransplantation bei Multipler Sklerose - wo stehen wir?
verfasst von
Prof. Dr. med. Christoph Heesen
Dr. med. Dr. rer. biol. hum. Max Kaufmann
Dr. med. Dietlinde Janson
Dr. med. Vivien Häußler
Prof. Dr. med. Nicolaus Kröger
Prof. Dr. med. Manuel A. Friese
Publikationsdatum
21.10.2022
Verlag
Springer Medizin
Erschienen in
InFo Neurologie + Psychiatrie / Ausgabe 10/2022
Print ISSN: 1437-062X
Elektronische ISSN: 2195-5166
DOI
https://doi.org/10.1007/s15005-022-3002-0

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