Long-Term Remissions With Use of High Dose Cyclophosphamide in Multiple Sclerosis

Background: In this study, the results of high dose intravenous monthly pulse CYC on patients with worsening relapsing-remitting multiple sclerosis (RRMS) and secondary progressive multiple sclerosis (SPMS) were evaluated. Methods: Fifty-six patients who presented with worsening RRMS (30) or SPMS (26) were to be treated with intravenous (IV) monthly pulse of 800 mg/m² CYC in the first year and bimonthly in the second year. We evaluated the results before treatment and after 12 and 24 months. Results: In the RRMS patients, after 2 years baseline EDSS had improved in 18, was unchanged in 5 and worse in 3. In RRMS group annual relapse rate was 0.92 at the beginning. it decreased to 0.23 in first year and to 0.23 in second year. The SPMS patients after 2 years baseline EDSS had improved in 5, was unchanged in 15 and worse in 3. In SPMS group annual relapse rate was 0.26 at the beggining. It decreased 0.13 in the first year and 0.04 in the second year. Conclusion: This study showed that high dose CYC treatment for two years was well tolerated and seemed effective for both RRMS and SPMS.