Autologous Stem Cell Transplant - Impact on Patients with Multiple Sclerosis


While many people are aware of stem cell therapy and its application on patients with Multiple Sclerosis, not many are familiar with Autologous Stem Cell Transplant. The procedure uses healthy stem cells from the patient’s body to replace damaged or diseased bone marrow. This procedure is also called “Autologous Bone Marrow Transplant.” Using your cells for a stem cell transplant offers several benefits over stem cells offered by a donor. For instance, there aren’t any incompatibility issues between the cells being transplanted and the existing cells. However, an Autologous Stem Cell Transplant is only possible when the body is producing enough healthy bone marrow cells. In that case, the cells can be gathered frozen and then safely stored to be used later.

For patients with Multiple Sclerosis, an autologous stem cell transplant is used for resetting the immune system to its baseline function. MS is an autoimmune disorder within the central nervous system and is characterized by subsequent gliosis loss and inflammatory demyelination. It is one of the most common causes of nontraumatic disability in adults, and every 1 in 1000 adults in the United States suffers from this condition.

In the last two decades, ASCT is being used increasingly for treating aggressive autoimmune diseases. As mentioned earlier, the ASCT is used for resetting the immune tolerance to recurring neuroinflammation and preventing its continuity. Compared to other treatments, the ASCT is an intensive one-off treatment that does not require any additional therapies afterward, neuroinflammation. Transplant-related mortality (TRM) in MS managed with HSCT was formerly considered a limiting factor but has decreased to less than 2% [2–8], probably due to the less toxic conditioning regimens currently administered. Recent data from over 1000 transplants have shown astounding results with over 90% greater survival rate in the last five years. The most frequent cause of morbidity and mortality has been autoimmune disease recurrence.

Previously reported characteristics of the ASCT or HSCT method include collecting stem cells from peripheral blood, administering cells on an out-patient basis, and avoiding cellular freezing and thawing to make things more cost-effective and increase viability hematopoietic cells in the graft. As expected, the modifications to traditional stem cell transplantation methods made the procedure affordable to patients living in socio-economically impoverished conditions.

All in All

Although still not considered the mainstream or standard therapy in managing some forms of MS, autologous HSCT has shown some promising results through several studies. The mortality rate of autologous HSCT was a solid argument precluding it as a viable therapeutic option in various diseases, but as both morbidity and mortality rates have decreased substantially in recent years, it appears to be gaining greater acceptance within the medical community.

References

Ruiz‐Argüelles, G.J., Olivares‐Gazca, J.C., Olivares‐Gazca, M., Leon‐Peña, A.A., Murrieta‐Alvarez, I., Cantero‐Fortiz, Y., Gomez‐Cruz, G.B., Ruiz‐Argüelles, A., Priesca‐Marin, M. and Ruiz‐Delgado, G.J., 2019. Self‐reported changes in the expanded disability status scale score in patients with multiple sclerosis after autologous stem cell transplants: real‐world data from a single center. Clinical & Experimental Immunology, 198(3), pp.351-358.

Ruiz-Argüelles, G.J. and Gómez-Almaguer, D., 2017. Hematopoietic stem cell transplants for persons with multiple sclerosis: Is this the best therapeutic option. Medicina Universitaria, 19(77), pp.208-209.

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