Cyclophosphamide therapy in pediatric multiple sclerosis
- 16 June 2009
- journal article
- research article
- Published by Ovid Technologies (Wolters Kluwer Health) in Neurology
- Vol. 72 (24), 2076-2082
- https://doi.org/10.1212/wnl.0b013e3181a8164c
Abstract
To review our multicenter experience with cyclophosphamide in the treatment of children with multiple sclerosis (MS). Retrospective chart review of children with MS treated with cyclophosphamide. Demographic, clinical, treatment, and MRI parameters were collected. We identified 17 children with MS treated with cyclophosphamide. All but one had worsening of Expanded Disability Status Scale scores or multiple relapses prior to treatment initiation. Children were treated with one of three regimens: 1) induction therapy alone; 2) induction therapy with pulse maintenance therapy; or 3) pulse maintenance therapy alone. Treatment resulted in a reduction in relapse rate and stabilization of disability scores assessed 1 year after treatment initiation in the majority of patients. Longer follow-up was available for most cases. Cyclophosphamide was well tolerated in most patients. However, side effects included vomiting, transient alopecia, osteoporosis, and amenorrhea. One patient developed bladder carcinoma that was successfully treated. Cyclophosphamide is an option for the treatment of children with aggressive multiple sclerosis refractory to first-line therapies. Recommendations regarding patient selection, treatment administration, and monitoring are discussed.This publication has 40 references indexed in Scilit:
- Natural History of Multiple Sclerosis with Childhood OnsetThe New England Journal of Medicine, 2007
- Acute transverse myelitis in childhoodNeurology, 2007
- Clinical features of children and adolescents with multiple sclerosisNeurology, 2007
- Immunomodulatory treatment of early onset multiple sclerosis: results of an Italian Co-operative StudyNeurological Sciences, 2005
- Acute Disseminated Encephalomyelitis in Children: Discordant Neurologic and Neuroimaging Abnormalities and Response to PlasmapheresisPEDIATRICS, 2005
- Treatment of progressive multiple sclerosis with pulse cyclophosphamidel methylprednisolone: Response to therapy is linked to the duration of progressive diseaseMultiple Sclerosis Journal, 1999
- Ovarian function following the treatment of childhood acute lymphoblastic leukaemiaMedical and Pediatric Oncology, 1993
- The Canadian cooperative trial of cyclophosphamide and plasma exchange in progressive multiple sclerosisThe Lancet, 1991
- Multiple sclerosis in childhood: Clinical profile in 125 patientsThe Journal of Pediatrics, 1987
- Intensive Immunosuppression in Progressive Multiple SclerosisThe New England Journal of Medicine, 1983