We hypothesized that NfL concentrations in the blood: (a) are higher in individuals with asymptomatic X-ALD or AMN compared to age-matched healthy controls; (b) correlate with disease activity and progression, as assessed by EDSS score; (c) is further aggravated with the onset of inflammatory CALD with clinical progression graded by the MRI severity score, and (d) are lowered in CALD patients upon HSCT. Here, NEFL is linked to adrenomyeloneuropathy.