Contributions
Abstract: P1198
Type: Poster
Abstract Category: Therapy - disease modifying - Immunomodulation/Immunosuppression
Mitoxantrone (MTX) represents a treatment option for the stabilization of patients with secondary progressive multiple sclerosis (SPMS). Cardiac toxicity and malignancies are the more serious adverse effects
Methods: One hundred patients with Secondary Progressive Multiple Sclerosis (mean EDSS 5.5±1.2) were treated with MTX. Demographic and MRI data, clinical course and adverse effects were evaluated. All patients were treated with 12mg/m2 MTX every three months. MTX dose was adjusted in case of leucopenia after the first dose.
All patients were submitted to M-mode and color Doppler echocardiography, prior to inclusion and every three months before MTX administration. Measurements of the left and right ventricular diastolic and systolic dimensions were obtained and the LV ejection fraction was calculated. Blood cells counts were monitored 10 and 20 days after MTX treatment
Results: One hundred patients, EDSS 5±2 were treated with MTX and received 7±2 infusions All patients received pretreatment with ondansetron. A stabilization of disability progression and a slight improvement in disability was found in patients with EDSS < 6. White blood cells decreased significantly 10 days after MTX treatment (3599 ± 830) but increased again 20 days after treatment (5400 ± 1200). One female patient 45 years old presented with severe leucopenia after 10 MTX infusions without any signs of infection. The bone-marrow biopsy revealed promyelocytic leukemia.
Two patients demonstrated a significant reversible decrease in ejection fraction following second infusion and MTX was discontinued. Diastolic dysfunction was found in 8 patients after the 5th infusion. All other patients had cardiac ejection fraction values within normal values (63,67±5.4). All pre-menopause female patients developed menstrual disorder. Ten patients developed recurrent urinary tract infections during MTX treatment.
Conclusion: A stabilization of disability was noted during MTX treatment. One patient (1%) presented with leukemia. During MTX treatment a careful follow up is mandatory.
Disclosure: C.Kilidireas: Biogen, Novartis, Teva, Merck-Serono
E.Andreadou : Biogen, Novartis, Teva, Merck-Serono
M.E. Evangelopoulos : Biogen, Novartis, Teva
Koutsis : Biogen, Novartis,
Anagnostouli : Biogen, Novartis,
Abstract: P1198
Type: Poster
Abstract Category: Therapy - disease modifying - Immunomodulation/Immunosuppression
Mitoxantrone (MTX) represents a treatment option for the stabilization of patients with secondary progressive multiple sclerosis (SPMS). Cardiac toxicity and malignancies are the more serious adverse effects
Methods: One hundred patients with Secondary Progressive Multiple Sclerosis (mean EDSS 5.5±1.2) were treated with MTX. Demographic and MRI data, clinical course and adverse effects were evaluated. All patients were treated with 12mg/m2 MTX every three months. MTX dose was adjusted in case of leucopenia after the first dose.
All patients were submitted to M-mode and color Doppler echocardiography, prior to inclusion and every three months before MTX administration. Measurements of the left and right ventricular diastolic and systolic dimensions were obtained and the LV ejection fraction was calculated. Blood cells counts were monitored 10 and 20 days after MTX treatment
Results: One hundred patients, EDSS 5±2 were treated with MTX and received 7±2 infusions All patients received pretreatment with ondansetron. A stabilization of disability progression and a slight improvement in disability was found in patients with EDSS < 6. White blood cells decreased significantly 10 days after MTX treatment (3599 ± 830) but increased again 20 days after treatment (5400 ± 1200). One female patient 45 years old presented with severe leucopenia after 10 MTX infusions without any signs of infection. The bone-marrow biopsy revealed promyelocytic leukemia.
Two patients demonstrated a significant reversible decrease in ejection fraction following second infusion and MTX was discontinued. Diastolic dysfunction was found in 8 patients after the 5th infusion. All other patients had cardiac ejection fraction values within normal values (63,67±5.4). All pre-menopause female patients developed menstrual disorder. Ten patients developed recurrent urinary tract infections during MTX treatment.
Conclusion: A stabilization of disability was noted during MTX treatment. One patient (1%) presented with leukemia. During MTX treatment a careful follow up is mandatory.
Disclosure: C.Kilidireas: Biogen, Novartis, Teva, Merck-Serono
E.Andreadou : Biogen, Novartis, Teva, Merck-Serono
M.E. Evangelopoulos : Biogen, Novartis, Teva
Koutsis : Biogen, Novartis,
Anagnostouli : Biogen, Novartis,