Multiple sclerosis and neoplasms: comorbid oncological pathology in patients with multiple sclerosis in the Rostov region

Objective: study of the structure of comorbid oncological pathology in patients with MS in the Rostov region. Description of the difficulties of differential diagnosis in patients with neoplasms and identification of features of the course of MS in patients with comorbid oncological pathology, first of all, the rate of increase in disability. Materials and methods: the study included 44 patients with significant comorbid oncological pathology (neoplasms of the central and peripheral nervous system, malignant tumors) using patient questionnaires, laboratory and instrumental research methods. Statistical processing of the obtained results was carried out using the Mann-Whitney U test for comparison of independent samples. Results: currently, among the living patients with MS we observed, a combination of oncological pathology with demyelinating disease was identified in 38 women and 6 men aged 35 to 63 years (average age 47.64 +/- 8.25 years). The average age of detection of oncological pathology in the patients with MS we observed was 40.23+/-7.66 years. All 33 patients with malignant neoplasms of various localizations received surgical treatment, followed by chemotherapy (in 10 patients) and/or radiation therapy (in 4 patients); 16 of them, after curing the oncological pathology, resumed first-line DMT therapy. The average annual increase in the EDSS score for each patient with MS in the presence of comorbid oncological pathology and for patients with MS without a concomitant oncological process indicates that the presence of concomitant oncological pathology does not influence the rate of annual increase in the EDSS score of the patients we observe. Conclusions: in accordance with global data, the majority of patients with comorbid cancer pathologies were represented in the age group over 60 years, with the average patient age being 40.2 years. When assessing the dynamics of the EDSS score increase, no significant differences were identified in the clinical course of MS in patients with and without comorbid cancer. Further study of competing oncological pathologies in MS will allow us to develop formal algorithms for patient management and optimize the choice of treatment both in terms of the neoplastic process and in relation to long-term therapy of MS.

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