Glioblastoma Associated with Multiple Sclerosis: Coincidence or Induction?

Aarli, Johan A.; Mørk, S.J.; Myrseth, Erling; Larsen, John Ludvig

doi:10.1159/000116437

Cited by 25 publications

(18 citation statements)

References 7 publications

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“…Craniospinal irradiation has been tested as therapy for MS patients and was not found to be beneficial. [34][35][36][37][38][39][40][41][42] Tumoricidal doses of cranial radiation (Ͼ 4000 cGy) have been reported to be associated with both progression and exacerbation of MS in small numbers of patients. 36,37 Our ability to extrapolate these observations to the lower dose of radiation (1200 cGy) in our conditioning regimen is limited by the small number of patients and the difficulty in discriminating between radiationinduced neurologic damage and functional decline due to the primary disease process.…”

Section: Discussionmentioning

confidence: 99%

Hematopoietic stem cell transplantation for progressive multiple sclerosis: failure of a total body irradiation–based conditioning regimen to prevent disease progression in patients with high disability scores

Burt

Cohen

Russell

et al. 2003

Blood

190

121

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There were 21 patients with rapidly progressive multiple sclerosis (MS) treated on a phase 1/2 study of intense immune suppressive therapy and autologous hematopoietic stem cell (HSC) support with no 1-year mortality. Following transplantation, one patient had a confirmed acute attack of MS. Neurologic progression defined by the expanded disability status scale (EDSS) did not increase in disability by 1.0 or more steps in any of 9 patients with a pretransplantation EDSS of 6.0 or less. In 8 of 12 patients with high pretransplantation disability scores (EDSS > 6.0), progressive neurologic disability as defined by at least a 1-point increase in the EDSS has occurred and was manifested as gradual neurologic deterioration. There were 2 patients with a pretransplantation EDSS of 7.0 and 8.0 who died from complications of progressive disease at 13 and 18 months following treatment. Our experience suggests that intense immune suppression using a total body irradiation (TBI)-based regimen and hematopoietic stem cell transplantation (HSCT) are not effective for patients with progressive disease and high pretransplantation disability scores. Further studies are necessary to determine the role of intense immune suppressive therapy and HSC support in ambulatory patients with less accumulated disability and more inflammatory disease activity. Specifically, more patients and longer follow-up would be required in patients with an EDSS of 6.0 or less before drawing conclusions on this subgroup.

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Section: Discussionmentioning

confidence: 99%

Hematopoietic stem cell transplantation for progressive multiple sclerosis: failure of a total body irradiation–based conditioning regimen to prevent disease progression in patients with high disability scores

Burt

Cohen

Russell

et al. 2003

Blood

190

121

View full text Add to dashboard Cite

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“…There has been questioning of a possible pathological re- lationship between the two diseases, without conclusive evidence yet. Aarli et al 3 have also proposed the possibility of the immunosuppressive treatment for MSfacilitating the initiation of primary CNS tumors. However, none of the cases reported in the literature received full immunosuppressive treatment, including that in Aarli's report.…”

Section: Discussionmentioning

confidence: 99%

Spinal cord tumor in a patient with multiple sclerosis: case report

Taricco

Machado

Callegaro

et al. 2002

Arq. Neuro-Psiquiatr.

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-The association between multiple (MS) sclerosis and cerebral gliomas has been sporadically reported in the literature, causing a long lasting discussion if these lesions occur coincidentally or if MS plaques may actually lead to the genesis of gliomas. We report a 36 year old man who developed a rapid onset of right side weakness and loss of vision, having established a diagnosis of MS which was confirmed by CSF analysis and MRI. Nine years later he developed progressive tetraparesis, leading initially to suspicion of illness relapse and a demyelinating plaque in the spinal cord. However, after MRI investigation, a spinal cord tumor was diagnosed. The patient underwent cervical spine laminotomy for microsurgical removal of the spinal cord tumor diagnosed as ependimoma. The neurological deficits improved significantly.KEY WORDS: multiple sclerosis, gliomas, spinal cord tumors. T T T T Tumor de medula espinal em paciente com esclerose múltipla: relato de caso umor de medula espinal em paciente com esclerose múltipla: relato de caso umor de medula espinal em paciente com esclerose múltipla: relato de caso umor de medula espinal em paciente com esclerose múltipla: relato de caso umor de medula espinal em paciente com esclerose múltipla: relato de caso RESUMO -A associação entre esclerose múltipla (EM) e gliomas cerebrais foi relatada esporadicamente na literatura, levando a longa discussão quanto à possibilidade das placas de esclerose estarem envolvidas na etiologia dos gliomas ou dessas lesões ocorrerem coincidentemente. Relatamos um paciente de 36 anos que desenvolveu hemiparesia direita rapidamente progressiva e perda visual, sendo estabelecido o diagnóstico de EM após análise do LCR e imagens de RM de encéfalo. Após nove anos o paciente desenvolveu tetraparesia lentamente progressiva, levantando inicialmente a hipótese de atividade da doença e aparecimento de placa de EM na medula espinal. Contudo, após investigação com RM de coluna, um tumor medular foi diagnosticado. Foi então submetido a laminectomia cervical para ressecção microcirúrgica do tumor, que foi diagnosticado como ependimoma. Os déficits neurológicos melhoraram significativamente. PALAVRAS-CHAVE: esclerose múltipla, gliomas, tumores medulares.Multiple sclerosis (MS) is a demyelinating disease of the central nervous system (CNS) classically described as a relapsing-remitting disorder that affects multiple white-matter tracts, with usual onset in young adults and displaying marked clinical heterogeneity. The varied clinical features reflect the multifocal areas of CNS myelin destruction. The diagnosis of MS was traditionally based on clinical history, neurological examination and analysis of cerebrospinal fluid (CSF). Evoked potential examination and magnetic resonance imaging (MRI) have brought new aids to the diagnosis 1 . Frequently, a pattern of disseminated encephalomyelitis occurs, when several plaques of demyelinization can be observed throughout the neuroaxis. The plaques are typically surrounded by scar tissue, in which gliosis an...

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“…Aarli et al [56] reported a 63-year-old man who died of a cerebral tumor after the onset of MS. The autopsy revealed a glioblastoma which had developed adjacent to MS plaques, leading to the possibility that the induction of tumor-derived immune suppression might be associated with MS [56]. Subsequent relevant cases supporting this idea have also been reported [57][58][59].…”

Section: Equivocal Roles Of the Nervous System And The Immune System mentioning

confidence: 99%

“…Given the fact that cerebral tumors and MS relapses can show overlapping clinical and magnetic resonance imaging (MRI) features [56,59], the appearance of new neurological symptoms and signs in a patient with MS might be indicative of a reactivation of the disease. To better understand the underlying concurrence mechanisms in MS and cerebral tumors, we refer to Frisullo et al [60], who described a patient with relapsing-remitting MS with recent onset of new neurological signs due to glioblastoma multiforme with disturbances in the transcription factors pSTAT1, T-bet (Th1) and pSTAT3 (Th17) in circulating lymphocytes (e.g.…”

Section: Equivocal Roles Of the Nervous System And The Immune System mentioning

confidence: 99%

Janus head: the dual role of HLA-G in CNS immunity

Huang¹,

Airas

Schwab³

et al. 2010

Cell. Mol. Life Sci.

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The central nervous system (CNS) is considered an immune-privileged organ that maintains an adaptable immune surveillance system. Dysregulated immune function within the CNS contributes to the development of brain tumor growth, and robust immune activation results in excessive inflammation. Human lymphocyte antigen-G (HLA-G) proteins with tolerogenic immunoreactivity have been implicated in various pathophysiological processes including immune surveillance, governing homeostasis and immune regulation. In this review, we describe the wealth of evidence for the involvement of HLA-G in the CNS under physiological and pathological conditions. Further, we review regulatory functions that may be applicable as beneficial strategies in the therapeutic manipulation of immune-mediated CNS immune responses. Additionally, we try to understand how this molecule cooperates with other CNS-resident cells to maintain normal immune homeostasis, while still facilitating the development of the appropriate immune responses.

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Glioblastoma Associated with Multiple Sclerosis: Coincidence or Induction?

Cited by 25 publications

References 7 publications

Hematopoietic stem cell transplantation for progressive multiple sclerosis: failure of a total body irradiation–based conditioning regimen to prevent disease progression in patients with high disability scores

Hematopoietic stem cell transplantation for progressive multiple sclerosis: failure of a total body irradiation–based conditioning regimen to prevent disease progression in patients with high disability scores

Spinal cord tumor in a patient with multiple sclerosis: case report

Janus head: the dual role of HLA-G in CNS immunity

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