Stem Cell Transplantation Shows Benefit in MS

Autologous hemopoietic stem cell procedure may help patients with relapsing-remitting multiple sclerosis

MONDAY, Feb. 2 (HealthDay News) -- Autologous non-myeloablative hemopoietic stem cell transplantation may prevent neurological progression and improve neurological disability in relapsing-remitting multiple sclerosis, according to research published online Jan. 30 in The Lancet Neurology.

Richard K. Burt, M.D., of the Northwestern University Feinberg School of Medicine in Chicago, and colleagues analyzed data from 21 adults with relapsing-remitting disease who had failed to respond to at least six months of interferon beta therapy. Patients underwent autologous hemopoietic stem cell transplantation. Outcomes included progression-free survival as assessed by the Kurtzke expanded disability status scale (EDSS).

The mobilization and transplantation processes were well-tolerated; events following transplantation included five patients with neutropenic fever, two patients with dermatomal zoster, two patients with immune thrombocytopenia and a patient with C. difficile-related diarrhea, the report indicates. After a mean follow-up of 37 months, none had a decrease in EDSS score, indicating freedom from progression. At the most recent assessment, 17 (81 percent) showed at least a 1-point improvement in EDSS score compared to baseline, the researchers report.

"Five patients (23 percent) relapsed after six to 16 months and were then treated successfully with other immunosuppressive therapies; therefore, non-myeloablative conditioning regimens might not be sufficient to eradicate inflammatory activity in the long term. The study by Burt and colleagues is, however, the first report of a prospective single-center trial that has used such a regimen in patients with multiple sclerosis, and the results imply that this is a valuable alternative to the transplant conditioning therapies used so far," writes the author of an accompanying commentary.

The commentary author disclosed financial relationships with several pharmaceutical companies.

Abstract
Full Text (subscription or payment may be required)
Editorial

Physician's Briefing