IMMUNOSUPPRESSIVE TREATMENT OF MULTIPLE-S CLEROSIS WITH MITOXANTRONE

Preliminary clinical results indicate that the cytostatic agent mitoxa ntrone is an effective and very tolerable substance for treating multi ple sclerosis (ms). Our own experience, added to the findings of other pilot studies, seems to indicate that disease progression can be slow ed in a majority of patients with rapidly progressive ms. Mitoxantrone is mainly excreted by the hepato-biliary pathways and therefore it ca n be used in patients with renal insufficiency or chronic cystopyeliti s, a frequently occurring condition in ms. The side effects observed i n our therapeutic scheme which could be attributed to mitoxantrone wer e tolerable. Mild gastrointestinal complaints were occasionally report ed and vomiting was very rare. A carcinogenic effect from mitoxantrone has not been reported. A decrease in the leucocyte count is to be exp ected 6-15 days following treatment administration. Potential cardioto xicity represents the primary long term adverse reaction and thus pati ents with cardiovascular risk factors should not be treated with mitox antrone. Once a cumulative dosage of 140mg/m(2) is reached cardiac fun ction tests, including echocardiography with measurement of the left v entricular ejection fraction, should be routinely carried out preceedi ng each treatment administration in all patients. Mitoxantrone is curr ently not licensed for use in patients with ms and therefore should be restricted to patients with rapid disease progression where other gen erally accepted treatment modalities have failed.