More than 80% of adults with highly active relapsing-remitting multiple sclerosis (RRMS) were free from both relapses and disability worsening for two years. All credit goes to the stem cell transplant for helping, as per the real-world study in Denmark. The sources say that approximately two-thirds (69%) of these RRMS patients achieved a clinical outcome called NEDA-3. Even there is no evidence of disease activity defined as the absence of relapses, disability worsening, or new or enlarging lesions on MRI scans — after two years.
Stem cell therapy in Multiple Sclerosis has been associated with severe side effects and the result is no patient died and the procedure was completely safe. As per the researcher’s report, these outcomes may be largely attributed to a careful selection of patients and the use of a less toxic chemotherapy regimen prior to the transplant. The team said, “Our findings based on the study of 32 RRMS patients support the growing volume of evidence indicating that [stem cell therapy] is an effective and safe treatment with few serious [adverse events] and no mortality.”
Stem cell therapy also called Autologous hematopoietic stem cell transplant (aHSCT) is one of the top invasive procedures that has been intended to reset the immune system and stop the inflammatory attack that drives MS. The treatment of this procedure begins with collecting hematopoietic stem cells which give rise to mature immune cells from a patient’s blood. After this, the entire immune system is wiped out with the help of chemotherapy or radiation therapy regimens. When a patient’s own stem cells are used in this procedure, this whole procedure is called autologous. Doctors can also use donor stem cells here. One of the main intents of stem cell therapy in MS is to repopulate the immune system with healthy cells that won’t attack the nervous system.
Studies say the best outcomes after aHSCT occur in RRMS patients with highly active disease and it has been characterized by tons of relapses or MRI activity instead of treatment with disease-modifying therapies. Researchers at the Danish Multiple Sclerosis Center (DMSC), in Copenhagen, talked about this report that highlights experience with aHSCT for RRMS patients in Denmark with highly active disease.
More than 32 patients underwent stem cell therapy at the center in the decade from May 2011 to May 2021. There are around 7 patients that received chemotherapy conditioning BEAM/ATG and they have been told about a median follow-up of 49 months, or just longer than four years. The rest of the 25 patients were treated with a less aggressive chemotherapy regimen, called CY/ATG. It has been associated with a lower risk of side effects than BEAM/ATG. They have been told for a median of 39 months, or a little longer than three years.
If you compared with the BEAM/ATG patients, those patients who received CY/ATG were significantly younger. Moreover, those patients had a shorter disease duration and a lower annual relapse rate. The sources say these patients had less disability, as assessed by the Expanded Disability Status Scale (EDSS). It is useful to measure Multiple Sclerosis. 77% of patients did not have a relapse as of two years after aHSCT in the whole group.
The rate was genuinely higher in two-year relapse-free in the CY/ATG group compared with BEAM/ATG group (83% vs. 57%). The difference here was not statistically significant after they adjust multiple factors that simply affect prognosis like sex, age, disease duration, severity, and one-year relapse rate. The report says 79% of patients had not experienced a worsening in disability after two years. In the case of relapse rate, the proportion of patients without disability worsening was higher in CY/ATG versus BEAM/ATG (85% vs. 57%). Even after adjusting prognosis factors, the difference was not significant.
After receiving the confirmation of EDSS improvement, sustained easing in disability doors are opened and it was reported in one BEAM/ATG patient (14%) and six CY/ATG patients (24%). 93% of patients were free of new or enlarging lesions on MRI scans and around 69% demonstrated no evidence of disease two years after the procedure. These participants took the experience of hair loss during the mobilization step.
All patients who received BEAM/ATG had a host of side effects at the time of the pre-transplant chemotherapy regimen and these were: nausea, vomiting, diarrhea, infections, fever, fatigue, swelling in the digestive tract, and low levels of red blood cells, known as anemia. The team said, “In this retrospective study we demonstrate a high efficacy of AHSCT on disease activity in patients with RRMS. Our data also suggest that AHSCT with CY/ATG is at least as effective as with BEAM, with a lower risk of serious AEs.”
