Autologous haematopoietic stem cell transplantation with an intermediate intensity conditioning regimen in XXXX : the Italian multi-centre experience.

@entity1 @entity137 @entity15
BACKGROUND: Over recent years numerous @entity1 with severe forms of @entity15 ( @entity15 ) refractory to conventional therapies have been treated with intense immunosuppression followed by autologous haematopoietic stem cell transplantation (AHSCT). The clinical outcome and the @entity137 of AHSCT can be diverse, depending on the various types of conditioning protocols and on the disease phase. OBJECTIVES: To report the Italian experience on all the consecutive @entity1 with @entity15 treated with AHSCT with an intermediate intensity conditioning regimen, named BEAM/ATG, in the period from 1996 to 2008. METHODS: Clinical and magnetic resonance imaging outcomes of 74 @entity1 were collected after a median follow-up period of 48.3 (range = 0.8-126) months. RESULTS: Two @entity1 (2.7%) died from transplant-related causes. After 5 years, 66% of @entity1 remained stable or improved. Among @entity1 with a follow-up longer than 1 year, eight out of 25 subjects with a relapsing-remitting course (31%) had a 6-12 months confirmed Expanded Disability Status Scale improvement > 1 point after AHSCT as compared with one out of 36 (3%) @entity1 with a secondary progressive disease course (p = 0.009). Among the 18 cases with a follow-up longer than 7 years, eight (44%) remained stable or had a sustained improvement while 10 (56%), after an initial period of stabilization or improvement with median duration of 3.5 years, showed a slow disability progression. CONCLUSIONS: This study shows that AHSCT with a BEAM/ATG conditioning regimen has a sustained effect in suppressing disease progression in aggressive @entity15 cases unresponsive to conventional therapies. It can also cause a sustained clinical improvement, especially if treated subjects are still in the relapsing-remitting phase of the disease.
