Autologous hematopoietic stem cell transplantation (aHSCT) has shown promising results in the treatment of relapsing-remitting multiple sclerosis (MS), according to a recent study. aHSCT involves harvesting stem cells from the patient’s own bone marrow or blood, followed by chemotherapy and antibody treatment.
Although primarily used to treat blood cancers, emerging evidence suggests that aHSCT can also be effective in managing MS. However, it is not yet included in most national clinical guidelines. Researchers aimed to assess the safety and effectiveness of aHSCT when used as routine healthcare rather than under clinical trial conditions.
The study analyzed data from 231 patients with relapsing-remitting MS, of whom 174 had undergone aHSCT before 2020. The average age of these patients was 31, and the majority were women. The researchers evaluated the effectiveness of aHSCT by analyzing data from the Swedish MS registry and assessed its safety by reviewing the patients’ electronic medical records for 100 days following the procedure.
After an average follow-up period of nearly 3 years, 73% of patients showed no evidence of disease activity. This number increased to 65% after 10 years. Among the patients with some disability at the beginning of the study, over half showed improvement, while a third remained stable, and only a small proportion experienced worsening of symptoms.
The study also found a significant reduction in the relapse rate after aHSCT treatment. Patients experienced an average of 1.7 relapses in the year before aHSCT, compared to one relapse every thirtieth year after treatment.
While the study reported some side effects, including bacterial and viral infections, intensive care was only required for five patients, and no deaths occurred as a result of the treatment.
Although this study lacks a comparative group, the researchers emphasized that the results support the findings of the only randomized controlled trial conducted on aHSCT for MS. They concluded that aHSCT should be considered as a standard of care for highly active MS and could benefit a greater number of patients.
– Journal of Neurology, Neurosurgery & Psychiatry. (doi.org/10.1136/jnnp-2020-323992)