eligibility_summary
Eligible: adults 18–58 with RRMS or active SPMS, MRI T2 lesions in ≥2 typical locations (or spinal) plus recent activity (new T2 or Gd+), and relapse despite therapy (≥2 flares on interferon/copaxone in 12 mo, ≥1 on 2nd/3rd-gen DMT, or aSPMS with ≥2 Gd+ incl. one >5 mm). Excludes: CIS, isolated optic neuritis, PPMS/nonactive SPMS, EDSS<2, major organ/cardiac/hematologic disease, serious infections, cancer, pregnancy. DMT washouts required, no prior mitoxantrone/cladribine.
trial_source
clinical_trials.gov from Dec 2, 2025
annotation_status
ai
ai_summary
Trial: NCT05482542 (withdrawn). Population: highly active relapsing-remitting MS undergoing autologous hematopoietic stem cell transplantation (HSCT). Interventions (non-myeloablative conditioning before HSCT): 1) Cyclophosphamide + rabbit anti-thymocyte globulin (rATG). 2) Cyclophosphamide + rituximab. Drug types and mechanisms: • Cyclophosphamide: alkylating chemotherapeutic, DNA crosslinking → cytotoxic lymphodepletion, especially proliferating T/B cells. • rATG: polyclonal IgG antibody preparation, broad T-cell (and some B/NK) depletion via complement-dependent cytotoxicity, ADCC, and apoptosis. • Rituximab: chimeric monoclonal antibody against CD20, depletes CD20+ B cells (including memory B cells) via CDC/ADCC/apoptosis, spares plasma cells. Target cells/pathways: autoreactive T cells (rATG), CD20+ B cells (rituximab), and proliferating lymphocytes (cyclophosphamide), immune reconstitution via autologous HSCT to “reset” adaptive immunity and suppress MS inflammation.