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Fassas et al.<br />

Table 5. Trial 1: changes in the Kurtzke EDSS<br />

Post-SCT (months)<br />

Patient no. At entry 6 72 24 30<br />

Progressive MS from onset of disease<br />

Improved<br />

1. Primary 5 3.5 3 2 — 2<br />

5. Relapse 5 3 3.5 3.5 4<br />

13. Relapse* 7 5.5 — -t<br />

14. Primary 7.5 6.5 6.5 6.5<br />

Unchanged/stable<br />

8. Primary 6 6 — — —<br />

12. Primary 6.5 6.5 6.5 6.5 It<br />

15. Primary 6 6 6 6.5$<br />

Worsened<br />

3. Primary 6 6.5 6.5 6.5 1<br />

Secondary progressive MS<br />

Improved<br />

2. 7 6 6 6 6 6<br />

7. 5 2.5 2.5 3 3.5 3.5<br />

11. 7 6.5 6 6 6.5<br />

Unchanged/stable<br />

4. 6.5 6.5 — 6.5 —<br />

6. 6.5 6 6 6 6<br />

10.* 6 5.75 — 5.5 6<br />

Worsened<br />

9. 5 6 6 6 —<br />

*Gadolinium enhancement on MRIat entry; fno gadolinium enhancement; twill be con­<br />

sidered worsened if confirmed at next assessment.<br />

dose CY is desirable. After stem cell infusion, toxicity did not seem to differ from<br />

the toxicity occurring in patients undergoing autoSCT for lymphomas or solid<br />

tumors. Treatment-related mortality appears to be the same, around 5%, but even<br />

this may be unacceptable in patients suffering from a nonmalignant disease.<br />

Therefore, selection of patients with particularly adverse prognostic signs is of<br />

critical importance, although to define the pattern of deterioration in this disease is<br />

not easy. 1<br />

Milder conditioning regimens not carrying a high mortality risk could possibly<br />

be used instead of the BEAM, BUCY, or TBI. However, less intensive regimens<br />

are associated with high relapse rates in EAE 5<br />

<strong>and</strong> also in human rheumatoid<br />

arthritis. 18<br />

Moreover, it is necessary to perform some sort of adequate T cell<br />

depletion because high lymphocyte doses 8<br />

or unmanipulated grafts 10<br />

are also<br />

459

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