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Old 10-13-2015, 04:58 PM
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Join Date: Jun 2008
Location: Albuquerque, NM
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Default STUDY: Quality of life for patients with multiple sclerosis treated with HSCT

Quality of life for patients with multiple sclerosis treated with autologous haematopoietic stem cell transplantation (AHSCT)

M. Smilowski1, L. Szczechowski1, G. Helbig2, M. Krawczyk-Kulis2, S. Kyrcz-Krzemien2
1Department of Hematology and Bone Marrow Transplantation, A.Mielecki Hospital of Medical University of Silesia, 2Department of Hematology and Bone Marrow Transplantation, School of Medicine in Katowice, Medical University of Silesia, Katowice, Poland

Background: Multiple sclerosis (MS) has a significant impact on patient`s quality of life (QoL) which depends on disability status, fatigue and mental health. Autologous haematopoietic stem cell transplantation (AHSCT) should be considered as a therapeutic approach for patients with aggressive relapsing-remitting MS (RRMS) and secondary progressive MS (SPMS) who failed the conventional therapy.

Objectives: To evaluate the QoL, fatigue and their relationship with neurological disability status in patients who underwent AHSCT for RRMS/SPMS.

Methods: Twenty six patients with refractory RRMS (22 patients) and SPMS (4 patients) who met the eligibility criteria for AHSCT and completed a 1 year observation. The eligibility criteria were consistent with the guidelines of the European Group for Blood and Marrow Transplantation (EBMT) from 2012. The patient`s QoL was evaluated using MSIS-29 scale (Multiple Sclerosis Impact Scale-29), MusiQol (Multiple Sclerosis International Quality of Life questionnaire). The fatigue was additionally evaluated using MFIS (Modified Fatigue Impact Scale). All scales are validated for polish population. The disability status was assessed using Expanded Disability Status Scale (EDSS). The examination was performed before AHSCT, and 6 and 12 months thereafter. All computations were performed using StatSoft Poland analysis software (version 9.0).

Results: The mean MSIS-29 score was 84 before transplant, and 77 and 62 at 6 and 12 months post-transplant, respectively (p< 0.05). The mean MFIS score before AHSCT was 34.7 and decreased to 28.9 and 25.2 at 6 and 12 months, respectively (p< 0,05). For the MusiQoL, the mean score was 42, 37 and 31 before AHSCT and 6 and 12 months thereafter, respectively. (p< 0.05). The median EDSS score was 6.0 before treatment and decreased to 5.5 and 5.25 at studied time points after transplant, respectively (p< 0,05). A positive correlation between EDSS and MSIS-29 (r=0,43; p< 0,05), MusiQoL (r=0,51; p< 0,05) and MFIS (r=0,38; p< 0,05) was observed.

Conclusions: AHSCT as a treatment option for aggressive RRMS and SPMS has a significant impact on QoL resulting in lower scores in MSIS-29, MusiQol and MFIS scales.
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