Autologous Stem Cell Transplant in Adult Multiple Sclerosis Patients: A Study from North India

Dayama, Aniruddha; Bhargava, Rahul; Kurmi, Santosh Raut; Jain, Sachin; Dua, Vivek

doi:10.4103/0028-3886.284385

Cited by 5 publications

(1 citation statement)

References 8 publications

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“…The other three intermediate-intensity regimen trials included mainly SPMS patients, with Cull et al providing the longest mFU of 3 years and describing disease stability in 69% of patients [ 62 ]. Although Dayama et al also reported encouraging results, the mFU was 0.7 years, and therefore too short to provide meaningful data [ 63 ]. The intermediate-intensity regimens were assessed in trials that enrolled a total of 106 patients, with some encouraging data and an interesting suggestion that lower EDSS score correlates with improved outcomes.…”

Section: Clinical Trials: Lymphoablativementioning

confidence: 99%

The current standing of autologous haematopoietic stem cell transplantation for the treatment of multiple sclerosis

et al. 2022

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Autologous haematopoietic stem cell transplantation (aHSCT) is gaining traction as a valuable treatment option for patients affected by severe multiple sclerosis (MS), particularly the relapsing–remitting form. We describe the current literature in terms of clinical trials, observational and retrospective studies, as well as immune reconstitution following transplantation, with a focus on the conditioning regimens used for transplantation. The evidence base predominantly consists of non-randomised, uncontrolled clinical trials or data from retrospective or observational cohorts, i.e. very few randomised or controlled trials. Most often, intermediate-intensity conditioning regimens are used, with promising results from both myeloablative and lymphoablative strategies, as well as from regimens that are low and high intensity. Efficacy of transplantation, which is likely secondary to immune reconstitution and restored immune tolerance, is, therefore, not clearly dependent on the intensity of the conditioning regimen. However, the conditioning regimen may well influence the immune response to transplantation. Heterogeneity of conditioning regimens among studies hinders synthesis of the articles assessing post-aHSCT immune system changes. Factors associated with better outcomes were lower Kurtzke Expanded Disability Status Scale, relapsing–remitting MS, younger age, and shorter disease duration at baseline, which supports the guidance for patient selection proposed by the European Society for Blood and Marrow Transplantation. Interestingly, promising outcomes were described for patients with secondary progressive MS by some studies, which may be worth taking into account when considering treatment options for patients with active, progressive disease. Of note, a significant proportion of patients develop autoimmune disease following transplantation, with alemtuzumab-containing regimens associated with the highest incidence.

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Section: Clinical Trials: Lymphoablativementioning

confidence: 99%

The current standing of autologous haematopoietic stem cell transplantation for the treatment of multiple sclerosis

et al. 2022

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Autologous Hematopoietic Stem-Cell Transplantation in Multiple Sclerosis: A Systematic Review and Meta-Analysis

et al. 2022

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Introduction:In 1995, the use of autologous hematopoietic stem-cell transplantation (AHSCT), which was previously used to treat hematological tumors, was introduced for severe autoimmune diseases such as multiple sclerosis (MS). AHSCT has proven its safety over the past few years due to technical advances and careful patient selection in transplant centers. While most studies have reported that AHSCT led to decreased Expanded Disability Status Scale (EDSS) scores, some patients reported increased EDSS scores following the procedure. Given the contradictory results, we aimed to conduct a comprehensive systematic review and meta-analysis to investigate the efficacy and safety of AHSCT. Methods: PubMed, Web of Science, and Scopus were searched in March 2022 using a predefined search strategy. We included cohort studies, clinical trials, case-control studies, and case series that investigated the efficacy or safety of AHSCT in patients with MS. PICO in the present study was defined as follows: problem or study population (P): patients with MS; intervention (I): AHSCT; comparison (C): none; outcome (O): efficacy and safety.

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Atypical Optic Neuritis: The Potential Red Flags

et al. 2022

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Autologous Stem Cell Transplant in Adult Multiple Sclerosis Patients: A Study from North India

Cited by 5 publications

References 8 publications

The current standing of autologous haematopoietic stem cell transplantation for the treatment of multiple sclerosis

The current standing of autologous haematopoietic stem cell transplantation for the treatment of multiple sclerosis

Autologous Hematopoietic Stem-Cell Transplantation in Multiple Sclerosis: A Systematic Review and Meta-Analysis

Atypical Optic Neuritis: The Potential Red Flags

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