Autologous hematopoietic stem cell transplantation, which is based on the use of the patient’s own stem cells from the patient’s own bone marrow or blood, is a therapy commonly used to treat blood cancers, but some scientists request that it may be a treatment for routine multiple sclerosis (MS).
As explained in a study published in the ‘Journal of Neurology Neurosurgery & Psychiatry’, there is increasing evidence showing that this therapy is suitable for the treatment of relapsing-remitting MS, characterized by different stages of inflammation causing varying degrees of residual disability.
However the autologous hematopoietic stem cell transplantation It is not yet included in most national clinical guidelines for the treatment of MS.
MS is one of the most common chronic inflammatory diseases of the central nervous system; It is estimated that it affects more than 2 million people worldwide, 47,000 people in Spain and about 600,000 in Europe. This happens when the immune system attacks the body itself, a phenomenon known as autoimmunity.
Some specialized centers have long offered this type of treatment for MS, including culture of stem cells from the patient’s bone marrow, the use of chemotherapy to suppress the patient’s immune system and reintroduction of stem cells into the bloodstream with the aim of ‘resetting’ the immune system to prevent it from continuing to attack its own body.
This research analyzes the safety and efficiency of this technique when used more often in clinical practice than in clinical trial conditions.
231 patients with relapsing-remitting MS participated in the study, 174 of whom were treated with autologous hematopoietic stem cell transplantation before 2020. The average age at the time of treatment was 31 years and almost two-thirds ( 64%) They are women.
Researchers at Uppsala University in Sweden evaluated the performance of autologous hematopoietic stem cell transplantation by analyzing data collected from the Swedish MS registry. And its safety was evaluated by examining patients’ electronic medical records for 100 days after the procedure.
Patients had their disease for more than 3 years, on average, and received an average of 2 cycles of standard treatment (disease-modifying drugs) before autologous hematopoietic stem cell transplantation; 23 did not receive any treatment.
About three years after undergoing autologous hematopoietic stem cell transplantation, 20 patients (11%) were given disease-modifying drugs.
The results of the study showed that there was no evidence of MS in almost three out of four (73%) of the treated patients after 5 years and in almost two thirds (65%) after 10 years.
Among 149 MS patients with some disability at onset, more than half (80) improved, more than a third (55) remained stable, and about 1 in 10 (14) worsened.
Regarding the annual relapse rate, it was 1.7 in the year before the transplant and 0.035 during the follow-up period. Or put another way, on average, a patient has 1.7 relapses in the year before cell therapy treatment and 1 relapses every thirty years after treatment.
The researchers found that 5 patients required intensive care and 61 developed bacterial infections within 100 days of treatment. Febrile neutropenia (low white blood cell count accompanied by high fever) was the most common side effect, affecting 68% of patients.
Although this is an observational study, without a comparison group, which prevents making definitive conclusions, the researchers wrote that the “findings show that the transfer for patients who have relapsing remitting MS. can be done within routine medical care and can be performed without compromising safetyd».
Therefore, they concluded that, considering that their study confirms the results observed in the only randomized controlled trial conducted so far, “we believe that autologous hematopoietic stem cell transplantation may benefit more patients with MS and should be included as a standard of care for very active MS.
