[Clinical course of multiple sclerosis in patients treated with cytostatic drugs for cancer]

Rev Neurol. 2009 Jan;48(2):71-4.
[Article in Spanish]

Abstract

Introduction: The risk of side effects secondary to global and non-specific immune suppression has limited the systematic application of immunosuppressive therapy in multiple sclerosis (MS). However, when a patient with MS develops a cancer, cytostatic drugs as treatment for the neoplastic process may induce improvement not only of the cancer but also of MS.

Case reports: We present a series of four women with clinically defined MS and subjected to cytostatic therapy (cisplatin, 5-fluorouracil, leukovorin, adriamycin, tamoxifen and anastrozole) after the development of cancer: two presented breast cancer, one colon cancer, and the fourth parotid gland malignancy. Their clinical and neuroimaging course is described, following chemotherapy for the malignant disease. None of the patients have suffered further MS outbreaks. The four women have improved and remain clinically stable after neoplastic treatment. Magnetic resonance imaging showed persistence of the same lesion burden in three patients, and reduction in the other. At the present one patient receives weekly intramuscular interferon-beta 1a, whereas the other did not received any treatment.

Conclusions: Probably there are no specific cytostatics for MS. Immunosuppressive therapy could be a therapeutic option among patients with an aggressive clinical course.

Publication types

  • Case Reports

MeSH terms

  • Adenocarcinoma / complications
  • Adenocarcinoma / drug therapy
  • Adenocarcinoma / surgery
  • Adult
  • Anastrozole
  • Antineoplastic Agents / therapeutic use*
  • Brain / pathology*
  • Breast Neoplasms / complications
  • Breast Neoplasms / drug therapy
  • Breast Neoplasms / radiotherapy
  • Breast Neoplasms / surgery
  • Carcinoma, Acinar Cell / complications
  • Carcinoma, Acinar Cell / drug therapy
  • Carcinoma, Ductal, Breast / complications
  • Carcinoma, Ductal, Breast / drug therapy
  • Carcinoma, Ductal, Breast / radiotherapy
  • Carcinoma, Ductal, Breast / surgery
  • Cisplatin / administration & dosage
  • Colonic Neoplasms / complications
  • Colonic Neoplasms / drug therapy
  • Colonic Neoplasms / surgery
  • Combined Modality Therapy
  • Cyclophosphamide / administration & dosage
  • Cytostatic Agents / therapeutic use*
  • Doxorubicin / administration & dosage
  • Female
  • Fluorouracil / administration & dosage
  • Humans
  • Immunosuppressive Agents / adverse effects
  • Immunosuppressive Agents / therapeutic use
  • Leucovorin / administration & dosage
  • Magnetic Resonance Imaging
  • Methylprednisolone / adverse effects
  • Methylprednisolone / therapeutic use
  • Multiple Sclerosis, Chronic Progressive / complications
  • Multiple Sclerosis, Chronic Progressive / pathology*
  • Multiple Sclerosis, Relapsing-Remitting / complications
  • Multiple Sclerosis, Relapsing-Remitting / drug therapy
  • Multiple Sclerosis, Relapsing-Remitting / pathology*
  • Neoplasms / complications
  • Neoplasms / drug therapy*
  • Nitriles / administration & dosage
  • Parotid Neoplasms / complications
  • Parotid Neoplasms / drug therapy
  • Parotid Neoplasms / radiotherapy
  • Parotid Neoplasms / surgery
  • Tamoxifen / administration & dosage
  • Triazoles / administration & dosage

Substances

  • Antineoplastic Agents
  • Cytostatic Agents
  • Immunosuppressive Agents
  • Nitriles
  • Triazoles
  • Tamoxifen
  • Anastrozole
  • Doxorubicin
  • Cyclophosphamide
  • Cisplatin
  • Leucovorin
  • Fluorouracil
  • Methylprednisolone