Chemotherapies and Stem Cell Transplantation for MS

Randomized controlled trials of azathioprine, methotrexate, cladribine, intravenous immunoglobulin and cyclophosphamide have not shovm definite modification to the aggressive course of PP MS (Leary and Thompson, 2005). However, these immunosuppressant therapies continue to be evaluated in patients with active aggressive MS. 

Evaluation of combination therapies including cyclophosphamide shov promise in decreasing the number of Gd-i-lesions 

Autologous hematopoietic stem cell transplantation (AHSCT) was evaluated in a group of MS patients with aggressive and advanced disease (Nash et al., 2003) with some promise but also wkh evidence that neurologic loss continued. One important hypothesis from that study was the discordant nature of inflammatory measures and functional deficits (Healey et al., 2004). 

Your brother had some double vision problems lately and has felt very rired. Your family physician sent him to a neurologist w ho scheduled several tests. On follow up, the neurologist says that your brother has optic neuritis that may potentially be associated with multiple sclerosis. The neurologist also recommends that your brother consider beginning an interferon 3 therapy. 

What clinical data would support initiating EFN 3 therapy even before a definitive diagnosis of MS  

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