AUTOLOGOUS HAEMATOPOIETIC STEM CELL TRANSPLANTATION IN MS. Issue 10 (9th September 2014)

• Record Type: Journal Article
• Authors: Nicholas, Richard; Silber, Eli; Brex, Peter; Kazmi, Majid; Muraro, Paolo
• Is Part Of: Journal of neurology, neurosurgery and psychiatry. Volume 85:Issue 10(2014)
• Page Start: e4
• Page End: e4
• Publication Date: 2014-09-09
• Subjects: EPILEPSY; Neurology -- Periodicals; Nervous system -- Surgery -- Periodicals; Psychiatry -- Periodicals; 616.8
• DOI: 10.1136/jnnp-2014-309236.136
• Languages: English
• ISSNs: 0022-3050

Abstract

Abstract : Introduction Autologous Haemopoetic Stem Cell Transplantation (AHSCT) has been used worldwide for aggressive multiple sclerosis (MS). We describe our current experience using this procedure and our plans to develop this service. Methods: Retrospective audit of AHSCT for MS from 2009–13. Patients were selected based on persistent clinical relapses, progressive neurological disability or MRI lesion activity despite use of disease-modifying treatments (DMTs). Results: As of January 2013, 7 subjects (3 female) had received AHSCT. Mean age at diagnosis was 26.6 years (range 18–47) and disease length at transplant was 9.6 years (range 2–19). Subjects received on average 2.1 DMTs (range 1–5) prior to AHSCT. The procedure was well tolerated; complications included infection (3) and diarrhoea (1) during the transplant. After the procedure 3 subjects had infections. Follow-up was for a mean of 16 months (range 5–37) in 6 subjects. Clinically 3 were better and 3 were stable. The EDSS was improved in 4, stable in 1 and worse in 1. Conclusion: AHSCT in this small cohort complications were tolerable and aggressive MS appeared to be stabilised. We have developed guidelines based on this experience and international consensus criteria from EBMT and CIBMTR for future of AHSCT at our centres.