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AUTOLOGOUS HAEMATOPOIETIC STEM CELL TRANSPLANTATION IN MS
  1. Richard Nicholas1,
  2. Eli Silber2,
  3. Peter Brex2,
  4. Majid Kazmi3,
  5. Paolo Muraro4
  1. 1Imperial College Healthcare NHS Trust
  2. 2King's College Hospital NHS Foundation Trust
  3. 3Guy's & St Thomas' NHS Foundation Trust
  4. 4Imperial College London

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.

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