MINNEAPOLIS – A new study shows that intense immunosuppression followed by a hematopoietic stem cell transplant can prevent multiple sclerosis (MS) -related disability from worsening in 71% of people with relapsing-remitting MS for up to 10 years after treatment. The research will be published in the online edition of Neurology®, the American Academy of Neurology’s medical journal, January 20, 2021.
The study also found that some people had their disability improved over 10 years after treatment. In addition, more than half of people with the secondary progressive form of MS had no worsening of symptoms 10 years after a transplant.
While most people with MS are first diagnosed with relapsing-remitting MS, which is characterized by relapses of symptoms followed by periods of remission, many people with relapsing-remitting MS eventually switch to secondary progressive MS, which does not have large fluctuations in symptoms but instead has a slow, steady one Worsening of the disease.
The study included autologous hematopoietic stem cell transplants, which used healthy blood stem cells from the participant’s own body to replace diseased cells.
So far, conventional treatments have prevented people with MS from experiencing more seizures and worsening symptoms, but not in the long term. Previous research shows that more than half of people with MS who take medication for their disease will still get worse over 10 years.
Our results are exciting as they show that hematopoietic stem cell transplants can prevent a person’s MS disability from worsening in the long term.
Study author Dr. med. Matilde Inglese from the University of Genoa in Italy and a member of the American Academy of Neurology. “
The study looked at 210 people with MS who received stem cell transplants from 1997 to 2019. Their average age was 35 years. Of these people, 122 had relapsing remitting MS and 86 had secondary progressive MS and two had primary progressive MS. The researchers rated the participants six months, five years, and ten years after their transplant.
Five years after the start of the study, the researchers found that 80% of people did not experience any worsening of their MS disability. At the 10-year mark, 66% had not yet experienced any deterioration in disability.
Looking only at the people with the most common form of MS, the researchers found that 86% of them had no disability worsening five years after their transplant. Ten years later, 71% still showed no deterioration in their disability.
People with progressive MS also benefited from stem cell transplants. The researchers found that 71% of people with this type of MS had no disability worsening five years after their transplant. Ten years later, 57% showed no deterioration in their disability.
Our study shows that intense immunosuppression followed by haematopoietic stem cell transplants should be considered as a treatment for people with MS, especially those who are unresponsive to conventional therapy.
Limitations of the study include that it was retrospective, did not include a control group, and the clinicians who helped measure participants’ disability were aware that they had received stem cell transplants, which could have resulted in a bias. Inglese said these limitations will be addressed in future research.
The study was supported by the Italian Multiple Sclerosis Foundation and the Elena Pecci Research Fund.
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