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[Original research] [Pediatrics]
Kirill Kirgizov; Elli Volkova; Sergei Piliya; Veronika Konstantinova; Svetlana Shulga; Oksana Blagonravova; Raisa Bembeeva; Elena Skopobogatova;
This article is dedicated to the unique experience of multidisciplinary team in high-dose chemotherapy followed by autologous hematopoietic stem cell transplantation (auto-HSCT) in children with severe refractory multiple sclerosis (MS), and also combined systemic and intrathecal target therapy with prolonged immunosupression in cases of neuromyelitis optica (NMO). Treatment of MS using combination of cyclophosphamide and antithymocyte globulin resulted in quick clinical stabilization and long-term (follow-up 6–40 months) clinical and radiological remission with positive dynamics according to the Expanede Disability Status Scale. In the patients with NMO target therapy with Rituximab allowed to achieve apparent improvement without side effects. According to the data of clinical observation most patients are now in remission. Multidisciplinary approach requires multidisciplinary team including not only of specialists in bone marrow transplantation, but also neurologists, specialists in laboratory and radiological diagnostics.
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Keywords: multiple sclerosis, neuromyelitis optica, children, high-dose chemotherapy, target therapy, multidisciplinary approach