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多发性硬化症中的自体造血干细胞移植:移植血液学家和肿瘤学家的当前文献综述及未来方向

Autologous Haematopoietic Stem Cell Transplantation in Multiple Sclerosis: a Review of Current Literature and Future Directions for Transplant Haematologists and Oncologists.

作者信息

Das Joyutpal, Sharrack Basil, Snowden John A

机构信息

Sheffield Institute for Translational Neuroscience, University of Sheffield, 385a Glossop Rd, Sheffield, S10 2HQ, UK.

Clinical Neurology, Academic Department of Neuroscience, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK.

出版信息

Curr Hematol Malig Rep. 2019 Apr;14(2):127-135. doi: 10.1007/s11899-019-00505-z.

Abstract

PURPOSE OF REVIEW

We summarise the current development of autologous haematopoietic stem cell transplantation (AHSCT) in treating multiple sclerosis (MS) and discuss future directions for the general neurologist, transplant haematologist and oncologist.

RECENT FINDINGS

AHSCT was initially performed to treat MS over 20 years ago. Over recent years, the evidence base has grown, especially in relapsing-remitting MS (RRMS), with significant improvements in safety and efficacy through better patient selection, choice of transplant technique and increase in centre experience. AHSCT is now a treatment option in very carefully selected patients with severe, treatment-resistant RRMS. However, it is important for transplant haematologists and oncologists to work closely with specialist MS neurologists in patient selection, during transplant and in long-term follow-up of patients. Data should be registered into international transplant registries and, ideally, patients should be enrolled on prospective clinical trials in order to build the evidence base and refine transplant techniques.

摘要

综述目的

我们总结了自体造血干细胞移植(AHSCT)治疗多发性硬化症(MS)的当前进展,并讨论了普通神经科医生、移植血液科医生和肿瘤内科医生未来的发展方向。

最新发现

20多年前就开始进行AHSCT治疗MS。近年来,证据基础不断扩大,尤其是在复发缓解型MS(RRMS)中,通过更好的患者选择、移植技术选择和中心经验的增加,安全性和疗效有了显著提高。AHSCT现在是经过非常仔细挑选的严重、治疗抵抗性RRMS患者的一种治疗选择。然而,对于移植血液科医生和肿瘤内科医生来说,在患者选择、移植期间和患者的长期随访中与MS专科神经科医生密切合作非常重要。数据应登记到国际移植登记处,理想情况下,患者应参加前瞻性临床试验,以建立证据基础并完善移植技术。

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本文引用的文献

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Multiple Sclerosis: Mechanisms and Immunotherapy.多发性硬化症:机制与免疫疗法。
Neuron. 2018 Feb 21;97(4):742-768. doi: 10.1016/j.neuron.2018.01.021.

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