BACKGROUND: Evidence suggests cladribine is an effective, safe and convenient disease modifying therapy (DMT) for people with multiple sclerosis (pwMS). OBJECTIVE: To report our clinical experience using cladribine in pwMS using a dosing scheme adapted to individual total lymphocyte count (TLC) thereby addressing a key safety concern raised in the rejection of oral cladribine by the European Medicines Agency in 2011. METHODS: Subcutaneous cladribine 10 mg/day was administered on up to seven days in five weeks to pwMS who had clinical and/or MRI disease activity. The number of injections was adjusted to individual TLC to avoid depletion below 0.5 × 10* 9/L (WHO Grade 3 or 4). Efficacy and safety were assessed. RESULTS: Forty-nine pwMS (31 women and 18 men, aged 44 years (SD=9 )) were followed up for a mean of 6 months after their first cladribine injection. Median EDSS at baseline was 5 (1–8, n=46). No serious treatment-related adverse event was observed, and neither any clinical disease activity. TLC dropped to between 0.5 and 1 × 10* 9/L while other white cells remained within normal range. CONCLUSION: Cladribine was well tolerated and led to controlled TLC depletion leaving other cell lines largely unaffected. So far no new disease activity has been detected. Follow-up continues.