A type of chemotherapy drug, called mitoxantrone, can potentially treat multiple sclerosis (MS) by suppressing blood cells that attack your myelin, the protective layer covering your brain and spinal nerves.
Approximately
The Food and Drug Administration (FDA) has approved
Mitoxantrone isn’t approved to treat people with primary progressive MS.
Chemotherapy is also sometimes combined with
This procedure involves:
- removing the stem cells from your bone marrow that produce blood cells
- undergoing a high dose of chemotherapy
- infusing the stem cells back into your blood
Read on to learn more about how chemotherapy is used to treat MS and when a doctor may recommend it.
What is chemotherapy?
Chemotherapy is a drug therapy that contains chemicals that destroy fast-growing cells in your body. It’s most often used to treat cancer.
Chemotherapy can damage healthy cells in your body that divide quickly such as cells in your hair follicles or gastrointestinal (digestive) tract. Many chemotherapy side effects develop from damage to these healthy cells.
MS is a progressive disorder that develops when your white blood cells attack the protective fatty layer around the nerves in your brain and spinal cord called myelin and
The chemotherapy drug mitoxantrone can potentially treat MS by suppressing the activity of white blood cells that attack myelin and reducing damage to your central nervous system.
An
Chemotherapy with an autologous bone marrow transplant may be a treatment option for people with
During an autologous bone marrow transplant, stem cells that create blood cells are removed from your bone marrow before you’re given chemotherapy. They’re reinfused into your blood afterward so that your immune system can regrow.
Mitoxantrone, sold under the brand name Novantrone, is the only chemotherapy medication that is FDA approved to treat MS in the United States.
The medication alemtuzumab (Lemtrada) is also FDA approved to treat MS. It’s considered a targeted therapy medication and not a traditional chemotherapy drug. It works by targeting a protein on your white blood cells called CD52. This reaction depletes and then repopulates white blood cells circulating in your blood.
Similar to alemtuzumab, rituximab (Rituxan) is also a targeted treatment that’s not necessarily considered chemotherapy. It’s also used in several different types of cancer treatment.
Promising new treatments
Chemotherapy combined with a bone marrow transplant is still considered an experimental procedure and hasn’t yet been FDA approved.
- carmustine
- etoposide
- cytarabine-arabinoside
- melphalan
- ATG
And the cyclophosphamide regimen, which includes:
- cyclophosphamide
- ATG
Mitoxantrone is typically given at a dosage of 12 milligrams per square meter (mg/m2) through an intravenous (IV) infusion for 5 to 15 minutes every 3 months. It can be highly toxic, so doctors usually administer a maximum lifetime dose of
The dosages and drugs used in chemotherapy combined with an autologous stem cell transplantation vary between clinical trials. The procedure generally consists of five phases:
- pretransplantation identification of potential risks
- stem cell removal
- chemotherapy
- reinfusion of stem cells
- supportive care posttransplantation
Chemotherapy drugs can cause many side effects. Congestive heart failure (CHF) is a rare complication that may occur
Other side effects can include:
- nausea
- vomiting
- diarrhea
- headache
- fatigue
- fever and chills
- mouth sores
- constipation
- flu-like symptoms
- abnormal urine color
- hair loss
- missed menstruation
Mitoxantrone has also been linked to an increased risk of developing acute myeloid leukemia.
Mitoxantrone has been associated with significant side effects. It’s
In a 2021
Progression of disability was seen in 21% of people who received rituximab and 32.9% of people who received mitoxantrone. Rituximab had a more favorable safety profile. The researchers concluded that mitoxantrone should only be used in rare and exceptional cases.
Chemotherapy combined with autologous stem cell transplant
Studies are still ongoing looking at the effectiveness of chemotherapy combined with an autologous stem cell transplant. In a 2022
A
In a 2017
Chemotherapy involves taking drugs that contain chemicals that kill cells in your body that multiply quickly.
The chemotherapy drug mitoxantrone is FDA approved to treat MS. It works by destroying the white blood cells that attack the protective layer around your nerves called myelin.
Chemotherapy combined with a stem cell transplant is an emerging treatment, but it still hasn’t been FDA approved to treat MS. It may be a treatment option for people with severe relapsing-remitting MS.