Haematopoietic Stem Cell Transplant versus Immune-Reconstitution Therapy in Relapsing Multiple Sclerosis
| dc.contributor.author | Atkins, Harold | |
| dc.contributor.author | Snowden, John A. | |
| dc.contributor.author | Kalincik, Tomas | |
| dc.contributor.author | Sharmin, Sifat | |
| dc.contributor.author | Roos, Izanne | |
| dc.contributor.author | Freedman, Mark S. | |
| dc.contributor.author | Massey, Jennifer | |
| dc.date.accessioned | 2026-03-27T13:42:12Z | |
| dc.date.available | 2026-03-27T13:42:12Z | |
| dc.date.issued | 2025-08-04 | |
| dc.description.abstract | In the treatment of relapsing-remitting multiple sclerosis, autologous haematopoietic stem cell transplant (AHSCT) and immune-reconstitution therapies show several similarities. These treatment strategies have not yet been compared head-to-head. This study emulated pairwise trials of comparative effectiveness of stem cell transplant versus immune-reconstitution therapies cladribine and alemtuzumab. This cohort/registry study of comparative treatment effectiveness included data from seven specialist multiple sclerosis centres with AHSCT programmes (RESCUE-MS) and international MSBase registry during 2006-2023. The study included patients with relapsing-remitting multiple sclerosis treated with AHSCT, cladribine or alemtuzumab, with a minimum of 2-months follow-up before commencing study therapy and >= 2 disability assessments after commencing the study therapy. Patients were matched on a propensity score derived from their clinical and demographic characteristics. The matched groups were compared according to annualized relapse rates, freedom from relapses and 6-month confirmed disability worsening and improvement (measured with the Expanded Disability Status Scale). The matching of 143 (stem cell) to 283 cladribine-treated patients and 134 (stem cell) to 562 alemtuzumab-treated patients reduced the measured differences between the groups by 98% and 96%, respectively. The matched patients had high mean disease activity (>0.8 relapses in the prior 2 years), mean Expanded Disability Status Scale scores of 3-4, and were followed-up for a mean of 3.8-3.9 (stem cell), 1.9 (cladribine) or 4.5 years (alemtuzumab). Compared with cladribine, stem cell transplant was associated with a lower risk of relapse [mean annualized relapse rate +/- standard deviation (SD): 0.05 +/- 0.28 versus 0.16 +/- 0.39, respectively; hazard ratio: 0.24; 95% confidence interval (CI): 0.15-0.41], similar risk of disability worsening (hazard ratio: 0.70; 95% CI: 0.34-1.43) and higher probability of disability improvement (hazard ratio: 2.19; 95% CI: 1.31-3.66). Compared with alemtuzumab, stem cell transplant was associated with a lower risk of relapses (mean annualized relapse rate +/- SD: 0.04 +/- 0.23 versus 0.09 +/- 0.21, respectively; hazard ratio: 0.52; 95% CI: 0.29-0.93), similar risk of disability worsening (hazard ratio: 0.95; 95% CI: 0.53-1.72) and higher probability of disability improvement (hazard ratio: 2.03; 95% CI: 1.23-3.34). Thirty-four per cent of patients treated with stem cell transplant experienced delayed complications, mainly infections. No treatment-associated deaths were reported. Among patients with active relapsing-remitting multiple sclerosis and moderate disability, AHSCT is superior to cladribine and alemtuzumab at suppressing relapses and enabling recovery of neurological function. The high effectiveness of stem cell transplant is likely attributable to a complex interplay between immune suppression and reconstitution. | |
| dc.description.sponsorship | This study was financially supported by National Health and Medical Research Council (fellowship 2026836, project grant 1129189) and Multiple Sclerosis Australia (projects 19-800 and 22-2-103). Part of the data acquisition was funded by the MS Foundation, Canada. All aspects of the study were completed independently and separately from the funders. | |
| dc.description.sponsorship | Tomas Kalincik and Sifat Sharmin had full access to all the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis. The MSBase Foundation is a not-for-profit organization that receives support from Merck, Biogen, Novartis, Bayer-Schering, Sanofi-Genzyme and Teva. The study was conducted separately and apart from the guidance of the sponsors. We thank the MSBase Operations team Charlotte Sartori, Eloise Hinson, Pamela Farr, Rein Moore, Dusko Stupar, Cynthia Tang and Sonya Smirnova. This study was financially supported by National Health and Medical Research Council (fellowship 2026836, project grant 1129189) and Multiple Sclerosis Australia (projects 19-800 and 22-2-103). Part of the data acquisition was funded by the MS Foundation, Canada. All aspects of the study were completed independently and separately from the funders. | |
| dc.description.sponsorship | Multiple Sclerosis Australia [19-800, 22-2-103]; National Health and Medical Research Council [1129189]; MS Foundation of Canada | |
| dc.description.sponsorship | Merck; M.S.I. Foundation; Biogen; MSBase Operations team Charlotte Sartori; MSBase Foundation; National Health and Medical Research Council, NHMRC, (2026836, 1129189); National Health and Medical Research Council, NHMRC; Multiple Sclerosis Australia, MSA, (22-2-103, 19-800); Multiple Sclerosis Australia, MSA | |
| dc.description.sponsorship | T.K. served on scientific advisory boards for MS International Federation and World Health Organisation, BMS, Roche, Janssen, Sanofi, Genzyme, Novartis, Merck and Biogen, steering committee for Brain Atrophy Initiative by Sanofi Genzyme, received conference travel support and/or speaker honoraria from WebMD Global, Eisai, Novartis, Biogen, Roche, Genzyme, Teva, BioCSL and Merck and received research or educational event support from Biogen, Novartis, Genzyme, Roche, Celgene and Merck. I.R. served on scientific advisory boards/steering committees for Novartis and Merck and received conference travel support and/or speaker honoraria from Roche, Novartis, Biogen, Teva, Sanofi-Genzyme and Merck. J.M. served on scientific advisory board for Roche, received conference travel support and/or speaker honoraria from Novartis, Biogen, Roche and Merck. I.S. received compensation for an educational activity from Biogen. O.T. received speaker honoraria from and served on scientific advisory boards for Biogen, Sanofi-Aventis, Merck and Novartis. L.B. received speaker honoraria from Novartis, and consultant fees from Viatris. E.K.H. received honoraria/research support from Biogen, Merck Serono, Novars, Roche, and Teva; has been member of advisory boards for Actelion, Biogen, Celgene, Merck Serono, Novars, and Sanofi Genzyme; received honoraria/research support from Biogen, Merck Serono, Novars, Roche, and Teva; has been member of advisory boards for Actelion, Biogen, Celgene, Merck Serono, Novars, and Sanofi Genzyme; and has been supported by the Czech Ministry of Education—project Cooperatio LF1, research area Neuroscience, and the project National Institute for Neurological Research (Programme EXCELES, ID project No LX22NPO5107)—funded by the European Union-Next Generation EU. M.T. received honoraria from Janssen, Gilead Sciences, Bristol-Myers Squibb, Takeda, Amgen, Abbvie, Roche, MorphoSys, Novartis, served as an advisor to Takeda, Bristol-Myers Squibb, Incyte, Abbvie, Amgen, Roche, Gilead Sciences, Janssen, MorphoSys, Novartis, and received conference travel support from Gilead Sciences, Takeda, Bristol-Myers Squibb, Roche, Janssen and Abbvie. R.M. received compensation for traveling, conference fees and consulting fees from Merck, Teva, Sanofi Genzyme, Biogen Idec, Novartis, Roche, BMS, Celgene. W.B. reports speaking honoraria from The Corpus, Biogen and Novartis; and advisory board fees from Biogen and Intesso. A.v.d.W. served on advisory boards and receives unrestricted research grants from Novartis, Biogen, Merck and Roche She has received speaker’s honoraria and travel support from Novartis, Roche, and Merck. She receives grant support from the National Health and Medical Research Council of Australia and MS Research Australia. H.B. received institutional (Monash University) funding from Biogen, Roche, Merck, Alexion and Novartis; has carried out contracted research for Novartis, Merck, Roche and Biogen; has taken part in speakers’ bureaus for Biogen, Novartis, Roche and Merck; has received personal compensation from Oxford Health Policy Forum for the Brain Health Steering Committee. B.v.W. has received speaker fees, research support and travel grants from Almirall, Actelion/Janssen, Bayer, Biogen, Celgene/BMS, Imcyse, Merck, Novartis, Roche, Sanofi Genzyme and Teva. J.L.-S. travel compensation from Novartis, Biogen, Roche and Merck. Her institution receives the honoraria for talks and advisory board commitment as well as research grants from Biogen, Merck, Roche and Novartis. M.B. received compensation for speaking from Biogen, Merck, Roche, Alexion and Novartis. His institution has received research support from Biogen, Roche, Merck, BMS, Alexion and Novartis. He is a co-founder of RxPx and Sydney Neuroimaging Analysis Centre. G.L. received travel and/or consultancy compensation from Sanofi-Genzyme, Roche, Teva, Merck, Novartis, Celgene, Biogen. B.W. received honoraria for acting as a member of Scientific Advisory Boards/Consultancy for Alexion, Almirall, Biogen, Celgene/BMS, Merck, Janssen, Novartis, Roche, Sandoz, Sanofi-Genzyme and speaker honoraria and travel support from Biogen, Celgene/BMS, Merck, Novartis, Roche, Sanofi-Genzyme; research and/or patient support grants from Biogen, Janssen, Merck, Sanofi-Genzyme, Roche. Honoraria and grants were paid to UZA/UZA Foundation. Furthermore, B.W. received research funding from FWO-TBM, Belgian Charcot Foundation, Start2Cure Foundation, Queen Elisabeth Medical Foundation for Neurosciences and the National MS Society USA. K.B. received speaker honoraria and/or education support from Biogen, Teva, Novartis, Genzyme-Sanofi, Roche, Merck and Alexion; has been a member of advisory boards for Merck and Biogen. O.S. received honoraria and consulting fees from Bayer Schering, Novartis, Merck, Biogen and Genzyme. S.H. has received consulting fees and speaker honoraria from Biogen, Novartis, Roche, Merck, and has received grants for her Institution from Biogen, Merck, Novartis, and Roche. J.E.M.-L. has received grants and consulting or speaking fees from Alexion, Almirall, Biogen, Bristol-Meyers-Squibb, Horizon, Janssen, Merck, Novartis, Roche, Sandoz and Sanofi. R.A. received honoraria as a speaker and for serving on scientific advisory boards from Bayer, Biogen, GSK, Merck, Novartis, Roche and Sanofi-Genzyme. J.P. accepted travel compensation from Novartis, Biogen, Genzyme, Teva, and speaking honoraria from Biogen, Novartis, Genzyme and Teva. M.F. received travel and meeting attendance support from Novartis, Biogen, Roche, Sanofi-Genzyme and Merck. A.S. received travel and meeting attendance support from Novartis, Biogen, Roche, Merck, Bristol, Sanofi-Genzyme, Almirall, Piam. S.E. have received speaker honoraria and consultant fees from Biogen Idec, Novartis, Merck, Janssen, Bristol-Meyers, Bayer, Sanofi Genzyme, Roche and Teva. P.M. received speakers fees and travel grants from Novartis, Biogen, T’évalua, Sanofi. N.J. is a PI on commercial MS studies sponsored by Novartis, Roche, Biogen and Sanofi. He has received speaker’s honoraria from Merck. He has had conference travel and registration reimbursement from Novartis. S.C.-R. has received in the past 3 years travel expenses for scientific meetings from Biopas, Roche, Merck, and Genzyme; compensation for consulting services or participation on advisory boards from Merck, Biogen-Idec, Sanofi and Novartis; lecture fees from Novartis, Merck, Sanofi, Janssen and Biogen-Idec; and research support from Biogen-Idec and Novartis. He is a subject editor on Multiple Sclerosis for Acta Neurológica Colombiana and a member of the editorial board of Frontiers of Neurology. J.O. has received research funding from the MS Society of Canada, National MS Society, Brain Canada, Biogen, Roche, EMD Serono (an affiliate of Merck KGaA); and personal compensation for consulting or speaking from Alexion, Biogen, Celgene (BMS), EMD Serono (an affiliate of Merck KGaA), Novartis, Roche, and Sanofi-Genzyme. J.L.S.-M. accepted trave compensation from Novartis, Merck and Biogen, speaking honoraria from Biogen, Novartis, Sanofi, Merck, Almirall, Bayer and Teva and has participated in clinical trials by Biogen, Merck and Roche. F.P. received personal compensation for serving on advisory board by Almirall, Alexion, Biogen, Bristol, Janssen, Merck, Novartis and Roche. He further received research grant by Alexion, Almirall, Biogen, Bristol, Merck, Novartis and Roche and by FISM, Reload Association (Onlus), Italian Health Minister, and University of Catania. Y.B. received speaker honoraria/consulting fees from Merck, Biogen, Roche, Brystol, Novartis, Sanofi and Sandoz. P.G. has served in advisory boards for Novartis, EMD Serono, Roche, Biogen idec, Sanofi Genzyme, Pendopharm and has received grant support from Genzyme and Roche, has received research grants for his institution from Biogen idec, Sanofi Genzyme, EMD Serono. J.S. declares honoraria for educational events from Jazz, Gilead, Janssen, for advisory board membership from Medac, and for trial IDMC membership from Kiadis Pharma. The remaining authors report no competing interests. | |
| dc.description.sponsorship | Merck KGaA; MS Research Australia; Novartis; Merck; Monash University; FISM; Teva; Gilead; Czech Ministry of Education; Reload Association; Roche; EMD Serono; National Health and Medical Research Council of Australia; M.S.I. Foundation; Merck; Kiadis Pharma; Biogen; Genzyme; MSBase Operations team Charlotte Sartori; Queen Elisabeth Medical Foundation for Neurosciences; MSBase Foundation; FWO-TBM; Belgian Charcot Foundation; Italian Health Minister, and University of Catania; European Union-Next Generation EU; Actelion; Start2Cure Foundation; Biogen; Janssen; National MS Society; Bayer; Multiple Sclerosis Australia, MSRA, (22-2-103, 19-800); National Health and Medical Research Council, NHMRC, (2026836, 1129189); National Institute for Neurological Research, (LX22NPO5107) | |
| dc.identifier.doi | 10.1093/brain/awaf286 | |
| dc.identifier.issn | 0006-8950 | |
| dc.identifier.issn | 1460-2156 | |
| dc.identifier.scopus | 2-s2.0-105032162808 | |
| dc.identifier.uri | https://hdl.handle.net/20.500.14365/8858 | |
| dc.identifier.uri | https://doi.org/10.1093/brain/awaf286 | |
| dc.language.iso | en | |
| dc.publisher | Oxford Univ Press | |
| dc.relation.ispartof | Brain | |
| dc.rights | info:eu-repo/semantics/openAccess | |
| dc.subject | Stem Cells | |
| dc.subject | Disease Modifying Therapy | |
| dc.subject | Relapses | |
| dc.subject | Disability | |
| dc.subject | Propensity Score | |
| dc.title | Haematopoietic Stem Cell Transplant versus Immune-Reconstitution Therapy in Relapsing Multiple Sclerosis | |
| dc.type | Article | |
| dspace.entity.type | Publication | |
| gdc.author.id | Van Wijmeersch, Bart/0000-0003-0528-1545 | |
| gdc.author.id | Sánchez Menoyo, José Luis/0000-0003-2634-8294 | |
| gdc.author.id | Massey, Jennifer/0000-0002-3238-4630 | |
| gdc.author.id | SNOWDEN, JOHN ANDREW/0000-0001-6819-3476 | |
| gdc.author.scopusid | 56600037900 | |
| gdc.author.scopusid | 7005452706 | |
| gdc.author.scopusid | 8365701900 | |
| gdc.author.scopusid | 57195070200 | |
| gdc.author.scopusid | 7203068442 | |
| gdc.author.scopusid | 57193406295 | |
| gdc.author.scopusid | 60438783300 | |
| gdc.author.wosid | Foschi, Matteo/ABR-7231-2022 | |
| gdc.author.wosid | Patti, Francesco/C-3300-2011 | |
| gdc.author.wosid | Krasulová, Eva/F-8993-2017 | |
| gdc.author.wosid | Roos, Izanne/ABO-3767-2022 | |
| gdc.author.wosid | McCombe, Pamela/C-9692-2010 | |
| gdc.author.wosid | Massey, Jennifer/HCI-2064-2022 | |
| gdc.author.wosid | Neri, Stefano/D-6772-2019 | |
| gdc.author.wosid | Ozakbas, Serkan/V-6427-2019 | |
| gdc.author.wosid | Torkildsen, Øivind/A-1606-2008 | |
| gdc.author.wosid | Willekens, Barbara/AAW-1790-2021 | |
| gdc.coar.access | open access | |
| gdc.coar.type | text::journal::journal article | |
| gdc.description.department | İzmir University of Economics | |
| gdc.description.departmenttemp | [Kalincik, Tomas; Sharmin, Sifat; Roos, Izanne; Buzzard, Katherine] Royal Melbourne Hosp, Neuroimmunol Ctr, Dept Neurol, Melbourne, Vic 3000, Australia; [Kalincik, Tomas; Sharmin, Sifat; Roos, Izanne] Univ Melbourne, Dept Med, CORe, Melbourne 3000, Australia; [Freedman, Mark S.] Univ Ottawa, Dept Med, Ottawa, ON K1N 6N5, Canada; [Freedman, Mark S.; Atkins, Harold] Ottawa Hosp, Res Inst, Ottawa, ON K1H 8L6, Canada; [Massey, Jennifer; Sutton, Ian] St Vincents Hosp Sydney, Dept Neurol, Sydney 2010, Australia; [Massey, Jennifer; Withers, Barbara] Univ New South Wales, St Vincents Clin Sch, Sydney 2010, Australia; [Sutton, Ian] Univ Sydney, Sydney 2006, Australia; [Withers, Barbara] St Vincents Hosp Sydney, Dept Haematol, Sydney 2010, Australia; [Burman, Joachim] Uppsala Univ, Dept Med Sci, Neurol, S-75237 Uppsala, Sweden; [Torkildsen, Oivind; Bo, Lars] Haukeland Hosp, Dept Neurol, N-5009 Bergen, Norway; [Lehmann, Anne Kristine] Haukeland Hosp, Dept Haematol, N-5009 Bergen, Norway; [Havrdova, Eva Kubala; Krasulova, Eva] Charles Univ Prague, Fac Med 1, Dept Neurol, Prague 12808, Czech Republic; [Havrdova, Eva Kubala; Krasulova, Eva] Charles Univ Prague, Fac Med 1, Ctr Clin Neurosci, Prague 12808, Czech Republic; [Havrdova, Eva Kubala; Krasulova, Eva; Trneny, Marek] Gen Univ Hosp, Prague 12808, Czech Republic; [Trneny, Marek] Charles Univ Prague, Fac Med 1, Dept Haematol, Prague 12808, Czech Republic; [Kozak, Tomas] Charles Univ Prague, Fac Med 3, Dept Haematol, Prague 10034, Czech Republic; [Kozak, Tomas] Univ Hosp Kralovske Vinohrady, Prague 10034, Czech Republic; [Macdonell, Richard] Austin Hlth, Dept Neurol, Melbourne 3084, Australia; [Macdonell, Richard] Univ Melbourne, Dept Med, Melbourne 3010, Australia; [Brown, J. William L.; Coles, Alasdair] Univ Cambridge, Dept Clin Neurosci, Cambridge CB2 1TN, England; [Brown, J. William L.; Coles, Alasdair] Addenbrookes Hosp, Dept Neurol, Cambridge CB2 0QQ, England; [Van Der Walt, Anneke; Butzkueven, Helmut; Skibina, Olga] Alfred Hosp, Dept Neurol, Melbourne 3004, Australia; [Van Der Walt, Anneke; Butzkueven, Helmut] Monash Univ, Sch Translat Med, Dept Neurosci, Melbourne 3800, Australia; [Van Wijmeersch, Bart] Univ MS Ctr, B-3900 Hasselt Pelt, Belgium; [Van Wijmeersch, Bart] Pelt & Hasselt Univ, Noorderhart Rehabil & MS, B-3500 Hasselt, Belgium; [Lechner-Scott, Jeannette] Univ Newcastle, Sch Med & Publ Hlth, Newcastle 2308, Australia; [Lechner-Scott, Jeannette] John Hunter Hosp, Dept Neurol, Hunter New England Hlth, Newcastle 2305, Australia; [Barnett, Michael] Univ Sydney, Brain & Mind Ctr, Sydney 2003, Australia; [Barnett, Michael] Royal Prince Alfred Hosp, Dept Neurol, Sydney 2006, Australia; [Laureys, Guy] Univ Hosp Ghent, Dept Neurol, B-9000 Ghent, Belgium; [Willekens, Barbara] Antwerp Univ Hosp, Dept Neurol, B-2650 Edegem, Belgium; [Willekens, Barbara] Univ Antwerp, Vaccine & Infect Dis Inst VAXINFECTIO, Fac Med & Hlth Sci, Lab Expt Hematol, B-2000 Antwerp, Belgium; [Willekens, Barbara] Univ Antwerp, Fac Med & Hlth Sci, Translat Neurosci Res Grp, B-2000 Antwerp, Belgium; [Buzzard, Katherine; Skibina, Olga] Box Hill Hosp, Dept Neurol, Melbourne 3128, Australia; [Buzzard, Katherine; Skibina, Olga] Monash Univ, Eastern Hlth Clin Sch, Melbourne 3800, Australia; [Di Gregorio, Maria] Univ Salerno, Neurol Unit, I-84084 Salerno, Italy; [Hodgkinson, Suzanne] Liverpool Hosp, Dept Neurol, Sydney 2170, Australia; [Ozakbas, Serkan] Izmir Univ Econ, Med Point Hosp, TR-35575 Izmir, Turkiye; [Ozakbas, Serkan] Multiple Sclerosis Res Assoc, TR-35575 Izmir, Turkiye; [Meca-Lallana, Jose E.] Virgen Arrixaca Clin Univ Hosp, Neurol Dept, Multiple Sclerosis CSUR & Clin Neuroimmunol Unit, Murcia 30120, Spain; [Meca-Lallana, Jose E.] Univ Catolica San Antonio, Clin Neuroimmunol & Multiple Sclerosis Cathedra, UCAM, Murcia 30107, Spain; [Alroughani, Raed] Amiri Hosp, Dept Med, Div Neurol, Sharq 9XQQ42, Kuwait; [Prevost, Julie] CSSS St Jerome, St Jerome, PQ, Canada; [Foschi, Matteo; Surcinelli, Andrea] S Maria Croci Hosp Ravenna, MS Ctr, Dept Neurosci, Neurol Unit, I-48100 Ravenna, Italy; [Foschi, Matteo] Univ Aquila, Dept Biotechnol & Appl Clin Sci, I-67100 Laquila, Italy; [Neri, Stefano] S Maria Croci Hosp Ravenna, Dept Diagnost Imaging, AUSL Romagna, I-48100 Ravenna, Italy; [Eichau, Sara] Hosp Univ Virgen Macarena, Dept Neurol, Seville 41009, Spain; [Mccombe, Pamela] Univ Queensland, Ctr Clin Res, Brisbane 4072, Australia; [Mccombe, Pamela] Royal Brisbane & Womens Hosp, Dept Neurol, Brisbane 4029, Australia; [John, Nevin] Monash Univ, Sch Clin Sci, Dept Med, Melbourne 3800, Australia; [John, Nevin] Monash Hlth, Dept Neurol, Clayton 3168, Australia; [Cardenas-Robledo, Simon] Hosp Univ Nacl Colombia, Ctr Esclerosis Multiple CEMHUN, Bogota 111711, Colombia; [Cardenas-Robledo, Simon] Univ Nacl Colombia, Fac Med, Dept Med Interna, Bogota 111321, Colombia; [Oh, Jiwon] Univ Toronto, St Michaels Hosp, Div Neurol, Toronto, ON M5S 3G3, Canada; [Sanchez-Menoyo, Jose Luis] Hosp Galdakao Usansolo, Dept Neurol, Galdakao 48960, Spain; [Sanchez-Menoyo, Jose Luis] Biocruces Bizkaia Hlth Res Inst, Gadalkao 48903, Spain; [Patti, Francesco] GF Ingrassia, Dept Med & Surg Sci & Adv Technol, I-95122 Catania, Italy; [Patti, Francesco] Univ Catania, Multiple Sclerosis Unit, AOU Policlin Rodol San Marco G, I-95124 Catania, Italy; [Gerlach, Oliver] Acad MS Ctr Zuyd, Zuyderland Med Ctr, Dept Neurol, NL-6162 BG Sittard Geleen, Netherlands; [Gerlach, Oliver] Maastricht Univ, Sch Mental Hlth & Neurosci, Dept Neurol, Med Ctr, NL-6229 HX Maastricht, Netherlands; [Blanco, Yolanda] Hosp Clin Barcelona, Ctr Neuroimmunol, Serv Neurol, Barcelona 08036, Spain; [Grammond, Pierre] CISSS Chaudiere Appalache, Levis, PQ G6V 2Y9, Canada; [Sharrack, Basil] Sheffield Teaching Hosp NHS Fdn Trust, Dept Neurol, Sheffield S5 7AU, England; [Sharrack, Basil] Sheffield Teaching Hosp NHS Fdn Trust, Sheffield NIHR Neurosci BRC, Sheffield S5 7AU, England; [Snowden, John A.] Sheffield Teaching Hosp NHS Fdn Trust, Dept Haematol, Sheffield S57AU, England | |
| gdc.description.endpage | 962 | |
| gdc.description.issue | 3 | |
| gdc.description.publicationcategory | Makale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanı | |
| gdc.description.startpage | 951 | |
| gdc.description.volume | 149 | |
| gdc.description.woscitationindex | Science Citation Index Expanded | |
| gdc.identifier.pmid | 40755195 | |
| gdc.identifier.wos | WOS:001692824600001 | |
| gdc.index.type | PubMed | |
| gdc.index.type | WoS | |
| gdc.index.type | Scopus | |
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