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Haematopoietic stem cell transplantation is able to control multiple sclerosis in patients who have failed modern disease modifying drugs
Over the last 30 years, disease-modifying drugs (DMDs) that target the immune system either by lymphocytoreduction or by modulating lymphocyte function have become available to treat multiple sclerosis. While all control the episodic acute inflammation of the central nervous system, disease activity ultimately breaks through inevitably resulting in progressive disabilities. It is against this background that the role of autologous haematopoietic stem cell transplantation (aHSCT) has been examined. A combination of antibody and chemotherapeutic agents destroys the autoreactive disease-mediating immune system while an infusion of an autologous haematopoietic stem cell graft accelerates haematopoietic reconstitution and provides the seeds for a naïve replacement immune system. Evidence supporting a role for aHSCT continues to accumulate through prospective phase II cohort studies, registry-based long-term follow-up observations …
Footnotes
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests None declared.
Patient consent for publication Not required.
Provenance and peer review Commissioned; internally peer reviewed.
Data sharing statement No additional unpublished information available.