Mitoxantrone in the treatment of multiple sclerosis:  a single-center experience

Özlem Taşkapılıoğlu; Deniz Kamacı Şener; Aslı Bahar Turan; Şükran Yurtoğulları; Ahmet Tütüncü; Sümeyye Güllülü; Gökhan Ocakoğlu; Ömer Faruk Turan

doi:10.4274/Tnd.38039

Özlem Taşkapılıoğlu¹, Deniz Kamacı Şener¹, Aslı Bahar Turan¹, Şükran Yurtoğulları¹, Ahmet Tütüncü², Sümeyye Güllülü², Gökhan Ocakoğlu³, Ömer Faruk Turan¹

¹Uludag University Medical Faculty, Neurology Department, Bursa
²Uludag University Medical Faculty, Cardiology Department, Bursa
³Uludag University Medical Faculty, Biostatistics Department, Bursa

Keywords: Multiple sclerosis, secondary progressive multiple sclerosis, immunosuppressive agents, immunomodulators, mitoxantrone

Abstract

OBJECTIVE: To investigate the secondary progressive multiple sclerosis (SPMS) patients treated with mitoxantrone (MIT) and discuss the effectiveness and side effects of MIT.

METHODS: We retrospectively investigated 48 SPMS patients who completed or were still receiving MIT treatment. Expanded Disability Status Scale (EDSS) scores of the patients were determined who had detailed examination before the treatment. Complete blood count, urine examination, chest x-ray, kidney and liver function tests, transthoracic echocardiography were performed at initiation and during follow-up and 10 mg/m2 MIT was administered every three months. The data were assessed in order to determine the effectiveness and side effects.

RESULTS: A total of 48 patients, 34 women and 14 men, had an age of 42 (26-55) years at the initiation of MIT treatment. The duration of the treatment was 12 (3-30) months. The median EDSS scores were 6 (4-8) before the treatment and 6 (4-9) after the treatment. EDSS scores improved in 6 patients, deteriorated in 12 patients and 30 patients remained with stable EDSS scores during the treatment. Seventeen patients had no side effects however 31 patients developed side effects.

CONCLUSION: On the basis of this study, which is a clinical assessment of the effectiveness and side effects of MIT, we conclude that MIT can limit disability in SPMS patients and it is useful in treating SPMS patients due to favorable risk-benefit ratio.