New autoimmune disorder development after immune reconstitution therapy for multiple sclerosis

Sci Rep. 2024 Dec 28;14(1):30991. doi: 10.1038/s41598-024-82196-y.

Abstract

Immune reconstitution therapy (IRT) is a relatively new and highly effective treatment option for multiple sclerosis (MS). Uncertainty regarding the development of autoimmune disorders (ADs) after some therapies remains. The aim of this study was to assess new AD development after IRT in MS patients and to describe the nature of those ADs and the time to onset. A total of 179 patients with relapsing multiple sclerosis (37 after autologous haematopoietic stem cell transplantation (AHSCT), 19 after alemtuzumab (ALE) and 123 after cladribine (CLA) treatment) over a ten year period were included in the study. ADs were observed in 6 patients (16.2%) after AHSCT, 8 patients (42.1%) after ALE and 2 patients (1.6%) after CLA treatment. ADs developed earlier after ALE infusions, but later after AHSCT except for cytopenias. Neurologists should be attentive to the development of secondary ADs after ALE and AHSCT in MS patients.

Keywords: Alemtuzumab; Autoimmune disorder; Autologous haematopoietic stem cell transplantation; Cladribine; Immune reconstitution therapy; Relapsing multiple sclerosis.

MeSH terms

  • Adult
  • Alemtuzumab* / adverse effects
  • Alemtuzumab* / therapeutic use
  • Autoimmune Diseases*
  • Cladribine / adverse effects
  • Cladribine / therapeutic use
  • Female
  • Hematopoietic Stem Cell Transplantation* / adverse effects
  • Hematopoietic Stem Cell Transplantation* / methods
  • Humans
  • Immune Reconstitution*
  • Male
  • Middle Aged
  • Multiple Sclerosis / drug therapy
  • Multiple Sclerosis, Relapsing-Remitting / drug therapy
  • Young Adult

Substances

  • Alemtuzumab
  • Cladribine