Consensus guidelines for the monitoring and management of metachromatic leukodystrophy in the United States
Cytotherapy. 2024 Apr 1:S1465-3249(24)00579-6. doi: 10.1016/j.jcyt.2024.03.487. Online ahead of print.ABSTRACTMetachromatic leukodystrophy (MLD) is a fatal, progressive neurodegenerative disorder caused by biallelic pathogenic mutations in the ARSA (Arylsulfatase A) gene. With the advent of presymptomatic diagnosis and the availability of therapies with a narrow window for intervention, it is critical to define a standardized approach to diagnosis, presymptomatic monitoring, and clinical care. To meet the needs of the MLD community, a panel of MLD experts was established to develop disease-specific guidelines based on healthcare resources in the United States. This group developed a consensus opinion for best-practice recommendations, as follows: (i) Diagnosis should include both genetic and biochemical testing; (ii) Early diagnosis and treatment for MLD is associated with improved clinical outcomes; (iii) The panel supported the development of newborn screening to accelerate the time to diagnosis and treatment; (iv) Clinical management of MLD should include specialists familiar with the disease who are able to follow patients longitudinally; (v) In early onset MLD, including late infantile and early juvenile subtypes, ex vivo gene therapy should be considered for presymptomatic patients where available; (vi) In late-onset MLD, including late juvenile and adult subtypes, hematopoietic cell transplant (HCT) should be considered for patients with no or minimal disease involveme...
Source: Cancer Control - Category: Cancer & Oncology Authors: Laura A Adang Joshua L Bonkowsky Jaap Jan Boelens Eric Mallack Rebecca Ahrens-Nicklas John A Bernat Annette Bley Barbara Burton Alejandra Darling Florian Eichler Erik Eklund Lisa Emrick Maria Escolar Ali Fatemi Jamie L Fraser Amy Gaviglio Stephanie Keller Source Type: research
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