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Paramagnetic rim lesions on 7T MRI after autologous hematopoietic cell transplantation
Moein Amin1, Kunio Nakamura2, Bhaskar Thoomukuntla2
1Mellen Center for Multiple Sclerosis Treatment and Research, Cleveland Clinic, Cleveland, OH, USA.
Background:
Compared to the potent efficacy of autologous hematopoietic cell transplantation (AutoHCT) on multiple sclerosis (MS) lesion activity, benefit on disability progression is less clear. Paramagnetic rim lesions (PRLs) are imaging biomarkers associated with progression.
Objectives:
Evaluate effect of AutoHCT on PRLs using 7T magnetic resonance imaging (MRI).
Methods:
A single rater evaluated PRLs before/after AutoHCT on 7T MRI at an MS referral center.
Results:
Seven participants were included with mean age 38.9 years and median disease duration 9 years. Median PRL count pre-transplantation was 2. Post-AutoHCT (median 15 months in 5 participants) none of the PRLs resolved.
Conclusion:
These results provide low-level evidence that PRLs do not resolve following AutoHCT.
Insights
Autologous hematopoietic cell transplantation (AutoHCT) may not resolve paramagnetic rim lesions (PRLs) in multiple sclerosis (MS). This study found no resolution of PRLs after AutoHCT, suggesting limited impact on these specific disease markers.
Area of Science:
- Neuroimmunology
- Radiology
- Hematology
Background:
- Autologous hematopoietic cell transplantation (AutoHCT) shows potent efficacy for multiple sclerosis (MS) lesion activity.
- The impact of AutoHCT on disability progression in MS remains less clear.
- Paramagnetic rim lesions (PRLs) are identified as imaging biomarkers linked to MS progression.
Purpose of the Study:
- To evaluate the effect of AutoHCT on paramagnetic rim lesions (PRLs) in multiple sclerosis (MS).
- Utilizing high-resolution 7T magnetic resonance imaging (MRI) to assess PRL changes post-transplantation.
Main Methods:
- A single rater assessed PRLs on 7T MRI scans.
- Scans were obtained before and after AutoHCT in patients at an MS referral center.
- Seven participants with MS were included in the analysis.
Main Results:
- The median PRL count before AutoHCT was 2.
- Post-AutoHCT, assessed at a median of 15 months in 5 participants, no PRLs demonstrated resolution.
- The study included participants with a mean age of 38.9 years and a median disease duration of 9 years.
Conclusions:
- Paramagnetic rim lesions (PRLs) do not appear to resolve following autologous hematopoietic cell transplantation (AutoHCT).
- This suggests AutoHCT may not impact established PRLs in multiple sclerosis.
- Further research is needed to understand the long-term effects of AutoHCT on MS progression markers.
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