Articles

A Belgian consensus protocol for autologous haematopoietic stem cell transplantation in multiple sclerosis

BJH - volume 9, issue 5, september 2018

A. Van De Velde MD, B. Willekens , L. Vanopdenbosch MD, O. Deryck , D. Selleslag MD, M. D’Haeseleer , A. De Becker MD, B. Dubois MD, PhD, D. Dierickx MD, PhD, G. Perrotta , V. De Wilde MD, PhD, V. Van Pesch MD, PhD, N. Straetmans MD, PhD, D. Dive MD, Y. Beguin MD, PhD, B. Van Wijmeersch MD, PhD, K. Theunissen MD, T. Kerre MD, PhD, G. Laureys MD, PhD

SUMMARY

Multiple sclerosis is considered to be an immune mediated inflammatory disorder of the central nervous system. It mainly affects young, socioeconomic active patients. Although our armamentarium for this disease has significantly evolved in recent years some patients remain refractory to conventional therapies. In these cases, autologous haematopoietic stem cell transplantation can be considered as a therapeutic option. Decreasing morbidity, mortality and increasing patient awareness have led to rising inquiry by our patients about this treatment option. With the aim of a standardised protocol and data registration, a Belgian working party on stem cell therapy in multiple sclerosis was established. In this paper, we report the consensus protocol of this working party on autologous haematopoietic stem cell transplantation in multiple sclerosis.

(BELG J HEMATOL 2018;9(5):167–74)

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Management of immune thrombocytopenia in multiple sclerosis patients treated with alemtuzumab: a Belgian consensus

BJH - volume 9, issue 3, june 2018

C. Lambert MD, B. Dubois MD, PhD, D. Dive MD, A. Lysandropoulos MD, D. Selleslag MD, L. Vanopdenbosch MD, V. Van Pesch MD, PhD, B. Van Wijmeersch MD, PhD, A. Janssens MD, PhD

SUMMARY

Alemtuzumab (Lemtrada®) is a humanised monoclonal antibody indicated for the treatment of adult patients with relapsing/remitting multiple sclerosis with active disease defined by clinical or imaging features. Alemtuzumab demonstrated superior efficacy over active comparator in both treatment naive patients and those with inadequate response to prior therapy. Alemtuzumab is associated with a consistent and manageable safety and tolerability profile. Treatment with alemtuzumab for multiple sclerosis increases the risk for autoimmune adverse events including immune thrombocytopenia. Complete blood counts with differential should be obtained prior to initiation of treatment and at monthly intervals thereafter for 48 months after the last infusion. After this period of time, testing should be performed based on clinical findings suggestive of immune thrombocytopenia. If immune thrombocytopenia onset is confirmed, appropriate medical intervention should be promptly initiated, including immediate referral to a specialist. This paper presents the consensus of Belgian multiple sclerosis specialists and haematologists to guide the treating physician with practical recommendations.

(BELG J HEMATOL 2018;9(3):118–23)

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