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Abstract Details

The use of Autologous Haemopoetic Stem Cell Transplantation (AHSCT) in Multiple Sclerosis after Alemtuzumab treatment failure: a case series
Multiple Sclerosis
P12 - Poster Session 12 (12:00 PM-1:00 PM)
9-003

To highlight the use of AHSCT to control Relapsing Remitting Multiple Sclerosis (RRMS) after Alemtuzumab treatment failure.

Disease modifying therapies (DMT) for RRMS have been the mainstay of treatment for 20 years. Alemtuzumab is one of the most highly efficacious DMT for RRMS. However some patients continue to experience disease activity despite adequate Alemtuzumab therapy. AHSCT has been used with increasing frequency over the last decade to treat very active RRMS despite the use of DMTs. However efficacy and timing of delivering treatment in patients who failed Alemtuzumab remains unclear. Here we report a case series of patients with RRMS who received AHSCT after failing to respond to Alemtuzumab treatment.
A case series of all patients who received AHSCT for RRMS after failing to respond to a full course of Alemtuzumab was compiled. Details of 4 cases were collected from a national referral center in the north of England. Clinical details, MRI changes, efficacy and safety data related to the use of Alemtuzumab and AHSCT were recorded. AHSCT was performed using a standard Cyclophosphamide / ATG mobilization and conditioning regime.

All patients experienced clinical and radiological evidence of disease activity and progression whilst on Alemtuzumab. The mean treatment period with Alemtuzumab was 27 months (SD 23.2 months). Mean treatment courses was 2.5.  Mean follow up after AHSCT was 48.5 months (SD 32.7). No patient experienced further relapses or MRI disease activity following AHSCT. EDSS scores improved in all patients following AHSCT (mean 1.12 points, SD 0.62). Patients experienced routine grade 1-3 complications during transplantation period.  No autoimmune complications were recorded.

Our data suggests that AHSCT use is effective and safe in patients who failed to respond to Alemtuzumab. A larger cohort from clinical experience of AHSCT randomized control trials (STAR-MS) will help confirm findings.
Authors/Disclosures
Simon M. Bell, MBChB, MRCP (Sheffield Institute for Translational Neuroscience)
PRESENTER 		No disclosure on file
John Snowden John Snowden has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Vertex. John Snowden has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Jazz. John Snowden has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for BMS.
No disclosure on file
Joyutpal Das, MBBS Dr. Das has nothing to disclose.
Azza Ismail, MBBS, PhD, MRCP (Sheffield Teaching Hospitals) No disclosure on file
Basil Sharrack, MD, PhD, FÂ鶹´«Ã½Ó³»­ (Department of Neuroscience) Dr. Sharrack has nothing to disclose.