In the multiple sclerosis (MS) There is a destruction of myelin, a substance that covers the nerves, and this can cause very different symptoms that affect movement, sensitivity (tingling, numbness), eyes or cognition, among others. It is considered one of the main causes of disability due to illness in young adults, since it especially affects people between 20 and 45 years old.
MS has no cure, but treatments aimed at slowing its progression have been tested for years using what are known as disease-modifying therapies. One of these therapies is autologous hematopoietic stem cell transplant (hSCT)consisting of restart a patient’s immune system by first suppressing its activity with chemotherapy and then rebuilding it with the patient’s own stem cells, which have been obtained from their bone marrow or blood before treatment.
This has risks, since chemotherapy decreases the body’s defenses, making it easier to contract other diseases. However, a new study out of Sweden has now shown that transplanting stem cells taken from a person’s bone marrow or blood can safely slow the progression of multiple sclerosis. The results have been published in Journal of Neurology Neurosurgery & Psychiatry.
More than half of multiple sclerosis patients improved
The researchers decided to test the safety and effectiveness of HaHSCT to treat patients with relapsing-remitting MS, which is characterized by inflammatory episodes that cause different degrees of disability. To do this, they selected 231 patients with relapsing-remitting MS, 174 of whom had been treated with hHSCT before 2020 (the first of them received the treatment in 2004). At the time of treatment their average age was 31 years and 64% were women.
A retrospective analysis of prospectively collected data from the Swedish MS registry was carried out to evaluate the efficacy of the treatment, while procedure-related safety was assessed by analyzing data from electronic patient records covering a period of 100 days after the treatment. HSCT. On average, patients had been diagnosed with the disease for more than three years and had received an average of two sessions of standard treatment (disease-modifying drugs) before aHSCT; 23 had not received any treatment.
About three years on average after undergoing aHSCT, 20 patients (11%) received a disease-modifying drug. The trial results showed that there were no signs of disease activity in almost three in four (73%) people treated after five years and in almost two thirds (65%) after 10 years.
Among the 149 patients with multiple sclerosis who had some disability At the start of the study, more than half (54%;80) improved, just over a third (37%;55) remained stable and around one in 10 (9%;14) worsened. The annualized relapse rate was 1.7 the year before HSCT and 0.035 during the follow-up period, which was 5.5 years on average; That is, on average, a patient had 1.7 relapses in the year before aHSCT treatment, and 1 relapse every thirty years after aHSCT treatment.
Regarding the Adverse effects, five patients required intensive care and 61 developed a bacterial infection within 100 days of treatment. The febrile neutropenia (low white blood cell count accompanied by high fever) was the most common side effect, affecting 68% of patients. Other viral infections were observed in 23 patients (13%), three experienced reactivation of herpes zoster, and a localized fungal infection was confirmed in three. None died as a result of the treatment.
The authors acknowledge that, as this is an observational study whose results have not been compared with a control group, definitive conclusions cannot be drawn, but they highlight that their findings “demonstrate that HaHSCT for [EM remitente-recurrente] “It is feasible within routine healthcare and can be performed without compromising safety.”
“Our study corroborates the results observed in the only randomized controlled trial carried out to date,” they add. We believe that aHSCT could benefit a greater number of MS patients and should be included as a standard treatment for very active MS,” they conclude.