This treatment may change the course of CIDP, but ASCT is a toxic and demanding treatment

This treatment may change the course of CIDP, but ASCT is a toxic and demanding treatment. melphalan) followed by stem cell reinfusion (CD DNAPK 34+ cells). Recovery of peripheral blood cells occurred within 16 days. Prednisone was tapered Obatoclax mesylate (GX15-070) off but doses lower than 5 mg were accompanied by issues of Obatoclax mesylate (GX15-070) fatigue, probably due to adrenal insufficiency. He remained on this prednisone dose and experienced no additional immunosuppressive treatment. The only neurological sign that remained was slight numbness of his Obatoclax mesylate (GX15-070) fingertips. He worked well fulltime without limitations in his daily life activities. Remission after ASCT lasted 5 years. His relapse started with tingling in his ft and hands. The sensory symptoms progressed to his forearms and top legs, followed by diffuse weakness of the arm and leg muscles. He was no longer able to walk without assistance. Electrophysiological studies were repeated and showed deterioration (table 1). Standard blood checks were repeated and were no different from earlier test results. Table 1 Electrophysiological studies before and after relapse reported 14 individuals with severe MS who had been treated with ASCT. Three yr probability of progression free survival was 86% and that of disease activity free survival was 46%. On MRI, the mean switch in T2 lesion volume from baseline to the third yr was 20%.3 In a similar study in 16 individuals, 3 year progression free survival was 92% but 3 yr disease activity free survival was less than 20%.4 The conclusion from the experience in individuals with MS is that ASCT is not a definitive treatment of MS but may switch the aggressive course of the disease. Similarly, ASCT is probably not a definitive treatment for CIDP. This treatment may switch the course of CIDP, but ASCT is definitely a harmful and demanding treatment. The query is definitely whether related effects, as observed in our individual, can be obtained with less demanding treatments. LEARNING POINTS In the case reported here, there was a good medical response for 5 years followed by relapse. Instances of CIDP which relapse after stem cell therapy respond to standard treatment for CIDP. Acknowledgments This short article has been adapted with permission from Vermeulen M, vehicle Oers MHJ. Relapse of chronic inflammatory demyelinating polyneuropathy 5 years after autologous stem cell transplantation. J Neurol Neurosurg Psychiatry 2007;78:1154. Footnotes Competing interests: None. Referrals 1. Vermeulen M, Vehicle Oers MH. Successful autologous stem cell transplantation in a patient with chronic inflammatory demyelinating polyneuropathy. J Neurol Neurosurg Psychiatry 2002; 72: 127C8 [PMC free article] [PubMed] [Google Scholar] 2. Jaccard A, Royer B, Bordessoule D, et al. High-dose therapy and autologous blood stem cell Obatoclax mesylate (GX15-070) transplantation in POEMS syndrome. Blood 2002; 99: 3057C9 [PubMed] [Google Scholar] 3. Saiz A, Blanco Y, Carreras E, et al. Clinical and MRI end result after autologous haematopoietic stem cell transplantation in MS. Neurology 2004; 62: 282C4 [PubMed] [Google Scholar] 4. Fassas A, Anagnostopoulos A, Kazis A, et al. Autologous stem cell transplantation in progressive multiple sclerosisan interim analysis of effectiveness. J Clin Immunol 2000; 20: 24C30 [PubMed] [Google Scholar].