CYCLOPHOSPHAMIDE IN CHRONIC PROGRESSIVE MULTIPLE-SCLEROSIS - A COMPARATIVE-STUDY

No effective treatment is presently available for progressive multiple sclerosis (MS). Cyclophosphamide (CFX), a cytotoxic immunosuppressive drug widely used in systemic dysimmune diseases, has been proposed fo r the treatment of multiple sclerosis with different schedules and con troversial results. To evaluate the safety and clinical efficacy of CF X, we compared three different treatment schedules in patients with pr ogressive MS: induction followed by bimonthly boosters for one year (1 7 patients); bimonthly boosters for one year without previous inductio n (15 patients); and monthly boosters for one year (21 patients). Surv ival analysis showed that the percentage of stable patients was signif icantly higher in the first and third treatment schedule groups. Myelo toxicity occurred in patients treated with induction and boosters (Gro up A). A high incidence of broncopneumonia was observed in patients un dergoing the second treatment schedule (Group B). No major effects wer e observed in patients treated with monthly boosters (Group C). Respon se to treatment was limited to secondary progressive form. This study suggests that monthly treatment with CFX might be safely administered in progressive MS patients; its clinical efficacy must be confirmed by an appropriately designed clinical trial.