The cytostatic mitoxanthrone is since the mid-nineties a new possible way how to treat active MS. Its serious side-effect is cardiotoxicity. The objective of the presented work was to evalute the long-term effect of mitoxanthrone treatment and to compare the effect in different forms of the clinical course in 93 patients with active MS who were treated with 20 mg mitoxanthrone and 1 g methylprednisolone i.v. at one-month intervals, 6 times. The authors evaluated changes of EDSS after termination of treatment, 1 and 2 years after termination of treatment and changes of the relapse rate in the remittent and secondarily progressive form with relapses. The mean baseline EDSS of the whole group of patients was 5.09. After termination of mitoxanthrone therapy it declined to 4.89, 1 year after termination of therapy it was 4.94. 73 patients were followed up for 2 years after termination of treatment, their mean EDSS two years after termination of treatment was 5.23. The mean relapse rate dropped in the group of 31 patients with remittent or a secondarily progressive course with relapses during the first year from 2.2 to 0.58. 23 patients of this group were followed up for two years, their relapse rate declined during the second year to 0.78. The most marked effect was observed in patients with a relapse remittent course who improved after termination of treatment by almost 0.5 EDSS and two years after termination of treatment were in a better clinical condition than before its start. Serious side-effects included two severe infections, otherwise only mild signs of haematotoxicity were observed,ammenorrhoea, alopecia and gastrointestinal complaints. If the maximal dose is respected and side-effects are regularly monitored mitoxanthrone treatment is well tolerated and long-term effective in highly active MS, in particular in MS with a relapse-remitting course.

        Key words: active MS, mitoxanthrone, cardiotoxicity