In:
Multiple Sclerosis Journal, SAGE Publications, Vol. 24, No. 8 ( 2018-07), p. 1055-1066
Abstract:
Immunoablation and autologous hematopoietic stem cell transplantation (IA/aHSCT) halts relapses, white matter (WM) lesion formation, and pathological whole-brain (WB) atrophy in multiple sclerosis (MS) patients. Whether the latter was due to effects on gray matter (GM) or WM warranted further exploration. Objective: To model GM and WM volume changes after IA/aHSCT to further understand the effects seen on WB atrophy. Methods: GM and WM volume changes were calculated from serial baseline and follow-up magnetic resonance imaging (MRI) ranging from 1.5 to 10.5 years in 19 MS patients treated with IA/aHSCT. A mixed-effects model with two predictors (total busulfan dose and baseline T1-weighted WM lesion volume “T1LV”) characterized the time-courses after IA/aHSCT. Results: Accelerated short-term atrophy of 2.1% and 3.2% occurred in GM and WM, respectively, on average. Both busulfan dose and T1LV were significant predictors of WM atrophy, whereas only busulfan was a significant predictor of GM atrophy. Compared to baseline, a significant reduction in GM atrophy, not WM atrophy, was found. The average rates of long-term GM and WM atrophy were −0.18%/year (standard error (SE): 0.083) and −0.07%/year (SE: 0.14), respectively. Conclusion: Chemotherapy-related toxicity affected both GM and WM. WM was further affected by focal T1-weighted lesion-related pathologies. Long-term rates of GM and WM atrophy were comparable to those of normal-aging.
Type of Medium:
Online Resource
ISSN:
1352-4585
,
1477-0970
DOI:
10.1177/1352458517715811
Language:
English
Publisher:
SAGE Publications
Publication Date:
2018
detail.hit.zdb_id:
1290669-4
detail.hit.zdb_id:
2008225-3
Permalink