High-dose cyclophosphamide without stem-cell rescue for refractory CIDP

Brannagan, Thomas H.; Pradhan, Alyssa; Heiman‐Patterson, Terry; Winkelman, A Charles; Styler, Michael; Topolsky, David; Crilley, Pamela; Schwartzman, Robert J.; Brodsky, Isadore; Gladstone, Douglas E.

doi:10.1212/wnl.58.12.1856

Cited by 114 publications

(59 citation statements)

References 10 publications

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“…Azathioprine, cyclophosphamide, cyclosporine, interferon-alpha, interferon-beta, mycophenolate mofetil, and methotrexate have all been reported to be beneficial in CIDP patients not responsive to initial therapies [92][93][94][95][96][97][98][99][100][101][102][103][104][105][106][107][108]. For the most part, these studies were not prospective, randomized, or blinded.…”

Section: Treatmentmentioning

confidence: 99%

Chronic Inflammatory Demyelinating Polyneuropathy

Markvardsen

Harbo²,

Holbech³

et al. 2013

Encyclopedia of Pain

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Chronic Inflammatory polyneuropathies are an important group of neuromuscular disorders that present chronically and progress over more than 8 weeks, being referred to as chronic inflammatory demyelinating polyneuropathy (CIDP). Despite tremendous progress in elucidating disease pathogenesis, the exact triggering event remains unknown. Our knowledge regarding diagnosis and management of CIDP and its variants continues to expand, resulting in improved opportunities for identification and treatment. Most clinical neurologists will be involved in the management of patients with these disorders, and should be familiar with available therapies for CIDP. We review the distinctive clinical, laboratory, and electro-diagnostic features that aid in diagnosis. We emphasize the importance of clinical patterns that define treatment responsiveness and the most appropriate therapies in order to improve prognosis.

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Section: Treatmentmentioning

confidence: 99%

Chronic Inflammatory Demyelinating Polyneuropathy

Markvardsen

Harbo²,

Holbech³

et al. 2013

Encyclopedia of Pain

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“…23,74,75 A single patient with MMN, who responded partially to IVIg, improved after treatment with highdose cyclophosphamide without stem cell rescue and was able to discontinue IVIg treatment. 21 Cyclophosphamide-Adverse Events.…”

Section: Chemotherapymentioning

confidence: 99%

Current treatments of chronic immune‐mediated demyelinating polyneuropathies

Brannagan

2009

Muscle and Nerve

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Chronic inflammatory demyelinating polyradiculoneuropathy (CIDP), multifocal motor neuropathy (MMN), and anti-myelin-associated glycoprotein (anti-MAG) neuropathy are three demyelinating acquired neuropathies, with distinct responses to immunotherapy. In placebo-controlled, double-blind, randomized trials, intravenous immunoglobulin (IVIg) has been effective for CIDP and MMN, and plasmapheresis has been effective for CIDP. Corticosteroids have been beneficial in controlled trials for CIDP. Other agents, including cyclophosphamide, rituximab, azathioprine, cyclosporine, interferons, fludarabine, mycophenolate mofetil, and etanercept, have been reported to benefit some patients with inflammatory demyelinating neuropathies in case series and case reports. This review examines the use and toxicity associated with these immunotherapy medications in treating patients with chronic immune-mediated demyelinating neuropathies. Muscle Nerve, 2009.

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“…Brannagan and colleagues treated four patients with high-dose cyclophosphamide for refractory chronic inflammatory polyneuropathy; three had progressive disease and one had relapsing disease [39]. All four patients had improvement of strength and functional status, with three of four showing improvement in summated compound motor action potential.…”

Section: High-dose Cyclophosphamide For Other Autoimmune Diseasesmentioning

confidence: 99%

High Dose Cyclophosphamide Treatment for Autoimmune Disorders

Brodsky

2002

The Scientific World JOURNAL

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High-dose cyclophosphamide (200 mg/kg) was initially developed as a conditioning regimen for allogeneic bone marrow transplantation. Recently, high-dose cyclophosphamide without bone marrow transplantation has been employed as a method to induce durable treatment-free remissions in severe aplastic anemia and a variety of other severe autoimmune disorders. The premise underlying this approach is that high-dose cyclophosphamide is maximally immunosuppressive, but not myeloablative. Early hematopoietic stem cells are spared the cytotoxicity of cyclophosphamide because of their high levels of aldehyde dehydrogenase, an enzyme that confers resistance to the drug. Conversely, autoimmune effector cells (T cells, B cells, and NK cells) are exquisitely sensitive to high-dose cyclophosphamide because of their relatively low levels of aldehyde dehydrogenase. Intensive investigation is underway to determine which autoimmune disorders will most benefit and where in the natural history of these diseases to employ this rapidly developing therapy.KEY WORDS: high dose cyclophosphamide, autoimmune disease, aplastic anemia, autoimmune hemolytic anemia, bone marrow transplantation DOMAINS: autoimmunity, hematology, bone marrow failure, pharmacology, aplastic anemia, bone marrow transplantation.

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High-dose cyclophosphamide without stem-cell rescue for refractory CIDP

Cited by 114 publications

References 10 publications

Chronic Inflammatory Demyelinating Polyneuropathy

Chronic Inflammatory Demyelinating Polyneuropathy

Current treatments of chronic immune‐mediated demyelinating polyneuropathies

High Dose Cyclophosphamide Treatment for Autoimmune Disorders

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