Giedraitienė Nataša, Kizlaitienė Rasa, Kaubrys Gintaras
Clinic of Neurology and Neurosurgery, Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, Vilnius, Lithuania.
Sci Rep. 2024 Dec 28;14(1):30991. doi: 10.1038/s41598-024-82196-y.
Immune reconstitution therapy (IRT) is a relatively new and highly effective treatment option for multiple sclerosis (MS). Uncertainty regarding the development of autoimmune disorders (ADs) after some therapies remains. The aim of this study was to assess new AD development after IRT in MS patients and to describe the nature of those ADs and the time to onset. A total of 179 patients with relapsing multiple sclerosis (37 after autologous haematopoietic stem cell transplantation (AHSCT), 19 after alemtuzumab (ALE) and 123 after cladribine (CLA) treatment) over a ten year period were included in the study. ADs were observed in 6 patients (16.2%) after AHSCT, 8 patients (42.1%) after ALE and 2 patients (1.6%) after CLA treatment. ADs developed earlier after ALE infusions, but later after AHSCT except for cytopenias. Neurologists should be attentive to the development of secondary ADs after ALE and AHSCT in MS patients.
免疫重建疗法（IRT）是一种相对较新且对多发性硬化症（MS）非常有效的治疗选择。一些治疗后自身免疫性疾病（ADs）的发展仍存在不确定性。本研究的目的是评估MS患者接受IRT后新发ADs的情况，并描述这些ADs的性质和发病时间。在十年期间，共有179例复发型多发性硬化症患者纳入研究（37例接受自体造血干细胞移植（AHSCT）后，19例接受阿仑单抗（ALE）治疗后，123例接受克拉屈滨（CLA）治疗后）。AHSCT后有6例患者（16.2%）出现ADs，ALE治疗后有8例患者（42.1%）出现，CLA治疗后有2例患者（1.6%）出现。除血细胞减少症外，ADs在ALE输注后出现较早，但在AHSCT后出现较晚。神经科医生应关注MS患者在接受ALE和AHSCT后继发性ADs的发展。
