Review High-dose Cyclophosphamide Without Stem Cell Rescue in Autoimmune Diseases: A Systematic Review Carvalho 2024

Abstract
High-dose cyclophosphamide without stem cell rescue is a radical therapy for refractory autoimmune diseases.

The objective was to review the results of high-dose cyclophosphamide without stem cell rescue in autoimmune diseases. PubMed, Scielo, and Embase databases were systematically searched for articles on high-dose cyclophosphamide without stem cell rescue treating autoimmune diseases between 1966 and September 2022.

Twenty-nine studies were identified, including a total of 404 patients. The diseases most studied were systemic lupus erythematosus (n = 113), multiple sclerosis (n = 99), aplastic anemia (n = 86), and myasthenia gravis (n = 33). Most authors used the posology of 50mg/kg/day over four days of cyclophosphamide associated with Mesna, prophylactic antibiotics, G-CSF (granulocyte colony-stimulating factor), and support of red blood cells, and platelet transfusion.

The most common side effects were febrile neutropenia, alopecia, and gastrointestinal complaints. Regarding outcomes, most of the studies demonstrated improvement of the underlying autoimmune disease, some long-lived, but relapses and failures were also identified.

In conclusion, high-dose cyclophosphamide without stem cell rescue is an effective option for treating severe autoimmune diseases. This procedure is relatively safe when the appropriate supportive care measures are taken.

https://pmc.ncbi.nlm.nih.gov/articles/PMC11448757/

 

The abstract appears to completely miss the point that this is a treatment we have had experience of over a period of forty years that is universally considered of poor risk/benefit profile in the long term.

 

Hypothetically: which treatments would you deem acceptable / worth trying if a ME CFS patient would be requesting MAID as the QoL and symptoms have become too extreme severe and intolerable?
- and would want to take this risk as a last chance for a bearable / acceptable life?
(I myself would like to have options at hand in case things get worse)

Daratumumab, JAK-inhibitors, checkpoint inhibitors, Ampligen (probably not accessible), and more……