Evidence for acute XXXX after chemotherapy.

@entity1 @entity1010 @entity179 @entity1583 @entity27686 @entity15 @entity2359
OBJECTIVE: Chronic @entity2359 is a recognized long-term complication following chemotherapy in a range of diseases. @entity2359 adversely affects @entity1 ' quality of life. The objective of this study is to examine whether there is evidence of acute @entity2359 . METHODS: This prospective study included @entity1 with secondary progressive @entity15 (SPMS-BMT, n = 14) and @entity1583 (HM-BMT, n = 17) receiving chemotherapy as preconditioning for bone marrow transplant. The control groups included SPMS @entity1 matched for demographic and clinical data (SPMS-PL, n = 14) and healthy controls (n = 14). @entity179 was assessed at baseline and longitudinally (months 1, 2, 3, 6, 9, 12, 24, and 36), combining a clinical scale for disability (Expanded Disability Status Scale [EDSS]), a serum protein biomarker for @entity179 (neurofilaments, @entity27686 -SMI35), and @entity1010 measures (magnetic resonance imaging). RESULTS: Disability progression was significantly more acute and severe following chemotherapy compared to placebo. Immediately after starting chemotherapy, serum @entity27686 -SMI35 levels increased in 79% (p < 0.0001) of SPMS-BMT @entity1 and 41% (p < 0.01) of HM-BMT @entity1 compared to 0% of SPMS-PL @entity1 or healthy controls. In SPMS-BMT serum @entity27686 -SMI35 levels were > 100-fold higher 1 month after chemotherapy (29.73ng/ml) compared to baseline (0.28ng/ml, p < 0.0001). High serum @entity27686 -SMI35 levels persisting for at least 3 months were associated with sustained disability progression on the EDSS (p < 0.05). @entity1010 rates increased acutely in SPMS-BMT (-2.09) compared to SPMS-PL (-1.18, p < 0.05). INTERPRETATION: @entity2359 is an unwanted acute side effect of aggressive chemotherapy.
