MITOXANTRON THERAPY IN MULTIPLE-SCLEROSIS

Immunosuppressive treatment is used in active relapsing remitting mult iple sclerosis after failure of immunmodulatory therapy. It is also ap plied in severe secondary chronic-progressive MS. Two controlled clini cal trials reported therapeutic efficacy of the anthracendione mitoxan trone, with a significant reduction of relapses and/or progression of neurological deficits. A reduced number of Gd-enhancing lesions was de monstrated by MRI. In general, 10 mg mitoxantron/m(2) are given every three months for a period of two years. Main side effects are nausea, mild reversible alopecia, and secondary amenorrhaea. The incidence of malignomas does not seem to be increased after therapy. Application of mitoxantrone is limited by the potential development of dilatative ca rdiomyopathy at a total cumulative dosage of 150 mg/m(2) and above.