Long-term immunotherapy in MS

Abstract

Between 1972 and 1982, 42 patients with definite MS, in terms of McAlpine’s clinical criteria, and with oligoclonal pattern of IgG in CSF electrophoresis were treated continuously during 36 months either by cyclophosphamide (n = 22), azathioprine (n = 9), or succession of both drugs (n = 11). The doses of cyclophosphamide (mean 75 mg per day) and azathioprine (mean 100 mg per day) were progressively adjusted in each case to obtain a leukocyte count between 3000 and 4000 per mm³, controlled monthly. Urologic control was performed in cyclophosphamide group. All patients were still ambulant at the beginning of the treatment. The severity of symptoms were graded according to the Kurtzke disability status scale. Twenty patients (mean age: 32.5 ±2.9) were selected for this trial because of their relapse rate and severity of their residual symptoms uncontrolled by corticosteroid treatment. The 22 other patients (mean age: 48.6 ± 3.1) were in a progressive course at the beginning of treatment. In the first group (remitting progressive form), stabilization or regression of symptoms occurred in 15 patients out of 20. In the second group (progressive form), stabilization occurred in six patients out of 22.