作者
Fiona Roberts, Helen Hobbs, Helen Jessop, Cristina Bozzolini, Joachim Burman, Raffaella Greco, Azza Ismail, Majid Kazmi, Kirill Kirgizov, Gianluigi Mancardi, Susan Mawson, Paolo A Muraro, Mathieu Puyade, Riccardo Saccardi, Barbara Withers, Bregje Verhoeven, Basil Sharrack, John A Snowden
发表日期
2020/12/11
来源
Frontiers in Neurology
卷号
11
页码范围
556141
出版商
Frontiers Media SA
简介
Autologous haematopoietic stem cell transplantation (AHSCT) is increasingly used to treat people with multiple sclerosis (MS). Supported by an evolving evidence base, AHSCT can suppress active inflammation in the central nervous system and induce long-term changes in immune cell populations, thereby stabilizing, and, in some cases, reversing disability in carefully selected MS patients. However, AHSCT is an intensive chemotherapy-based procedure associated with intrinsic risks, including profound cytopenia, infection, and organ toxicity, accompanied by an on-going degree of immuno-compromise and general deconditioning, which can be associated with a transient increase in functional impairment in the early stages after transplantation. Although international guidelines and recommendations have been published for clinical and technical aspects of AHSCT in MS, there has been no detailed appraisal of the rehabilitation needed following treatment nor any specific guidelines as to how this is best delivered by hospital and community-based therapists and wider multidisciplinary teams in order to maximize functional recovery and quality of life. These expert consensus guidelines aim to address this unmet need by summarizing the evidence-base for AHSCT in MS and providing recommendations for current rehabilitation practice along with identifying areas for future research and development.
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