High-dose immunosuppressive therapy with autologous hematopoietic stem cells transplantation for multiple sclerosis: Current view

Abstract

Autologous hematopoietic stem cells transplantation (aHSCT) followed by high-dose immunosuppressive therapy is a promising and effective method of treating autoimmune diseases, including multiple sclerosis (MS). Over the past 15-20 years, frequency and severity of adverse events in aHSCT were decreased after reducing the intensity of conditioning regimens. Both better understanding of the immunological mechanisms of immune reconstitution and better approach to the selection of patients for this procedure also led to improved results.In view of increased incidence of multiple sclerosis worldwide, as well as insufficient effectiveness of standard therapy, the introduction of autologous transplantation into clinical guidelines for the MS treatment could maintain quality of life in the workforce population.

High-dose immunosuppressive therapy with autologous hematopoietic stem cell transplantation in multiple sclerosis: side effects and the tools of their reduction

“…In general, when using medium-intensity CR, the severity of HDIT complications according to the Common Terminology Criteria for Adverse Events (CTCAE 5.0) is mostly considered mild and moderate (Grade 0-3). Table 3 presents a list of potential late complications of HDIT-AHSCT when using the recommended protocols for MS [1,4,5,13,[19][20][21][30][31][32].…”

“…Analysis of research publications concerning the choice of optimal conditions and criteria for administering HDIT-AH-SCT in multiple sclerosis, as well as a description of the main stages of the method, was presented earlier [13].…”