Autologous haematopoietic stem cell therapy for multiple sclerosis: a review for supportive care clinicians on behalf of the Autoimmune Diseases Working Party of the European Society for Blood and Marrow Transplantation

Purpose of review In this review, we summarize the recently published literature that demonstrates the efficacy and safety of autologous haematopoietic stem cell therapy (AHSCT) in multiple sclerosis (MS) and highlight the importance of supportive care required for the safe and well-tolerated delivery of AHSCT. Recent findings MS is an autoimmune inflammatory and degenerative disorder of the central nervous system (CNS). In the majority of patients, the illness runs a relapsing remitting course (RRMS), culminating in a secondary progressive phase with gradual accumulation of fixed disabilities. Currently available disease-modifying therapies suppress CNS inflammation but have a limited effect on preventing disease progression for which there remains no effective therapy. Over the last two decades, there has been increasing evidence that AHSCT is a highly effective therapeutic strategy for treatment-resistant inflammatory types of MS, especially RRMS. Concerns about the safety of AHSCT in MS, usually a nonlife-threatening disease, have previously limited its use. However, AHSCT can now be delivered safely with major long-term benefits because of increasing transplant centre experience, judicious patient selection and good supportive care. Summary MS is currently the fastest growing indication for AHSCT in Europe. Supportive care before, during and after the transplant period is key to the successful delivery of AHSCT.
Source: Current Opinion in Supportive and Palliative Care - Category: Palliative Care Tags: BLOOD, BONE MARROW AND LYMPHATICS: Edited by Christopher Dalley Source Type: research

Related Links:

Publication date: Available online 13 December 2019Source: Brain, Behavior, and ImmunityAuthor(s): N.B. Teixeira, M.B. Sant'Anna, A.C. Giardini, L.P. Araujo, L.A. Fonseca, A.S. Basso, Y. Cury, G. PicoloAbstractMultiple sclerosis (MS) is a Central Nervous System inflammatory demyelinating disease that has as primary symptoms losses of sensory and motor functions, including chronic pain. To date, however, few studies have investigated the mechanisms of chronic pain in animal models of MS since locomotor impairments render difficult its evaluation. It was previously demonstrated that in the MOG35-55-induced EAE, an animal mod...
Source: Brain, Behavior, and Immunity - Category: Neurology Source Type: research
In conclusion, our data suggest that DKI and microstructural modeling can provide a unique contrast capable of detecting EAE-specific changes correlating with clinical disability.
Source: NeuroImage - Category: Neuroscience Source Type: research
Publication date: Available online 25 November 2019Source: Multiple Sclerosis and Related DisordersAuthor(s): Amy Kunchok, Charles Malpas, Petra Nytrova, Eva Kubala Havrdova, Raed Alroughani, Murat Terzi, Bassem Yamout, Jyh Yung Hor, Rana Karabudak, Cavit Boz, Serkan Ozakbas, Javier Olascoaga, Magdolna Simo, Franco Granella, Francesco Patti, Pamela McCombe, Tunde Csepany, Bhim Singhal, Roberto Bergamaschi, Yara FragosoABSTRACTBackgroundAquaporin-4-IgG positive (AQP4-IgG+) Neuromyelitis Optica Spectrum Disorder (NMOSD) is an uncommon central nervous system autoimmune disorder. Disease outcomes in AQP4-IgG+NMOSD are typicall...
Source: Multiple Sclerosis and Related Disorders - Category: Neurology Source Type: research
ConclusionsAlemtuzumab appears to be an effective and safe short-term therapeutic option both as a rescue therapy for the disease flare-up associated with fingolimod withdrawal, as well as for the reversal of the deteriorating course observed in patients who fail treatment with fingolimod.
Source: Multiple Sclerosis and Related Disorders - Category: Neurology Source Type: research
ConclusionsIn a real-world MS population like the one investigated in our study, alemtuzumab was found to be an effective treatment when employed as an escalation or rescue therapy. The compound exhibits a variable safety profile and frequent adverse events that are likely depending on previous treatments and their impact on the immune system.
Source: Multiple Sclerosis and Related Disorders - Category: Neurology Source Type: research
CONCLUSIONS: There were significant associations of risk T allel of the analyzed polymorphism with all studied autoimmune diseases (GDOR = 1.34, p = 7.02e-03; MSOR = 1.36, p = 2.17e-02; LADA - OR = 3.36, p = 8.73e-07). We also found that the frequency of CT and TT genotypes of the rs1990760 IFIH1 gene only in females (with LADA, GD, MS) was significantly higher than those in the female control group (47%, 41% vs 44%, 34%; p = 1.32e-03, p = 4.39e-04; OR = 2.08, 95%CI: (1.33-3.28), OR = 2.29, 95% CI: (1.44-3.65) respectively). Our research has shown significant differences regarding so...
Source: Immunobiology - Category: Allergy & Immunology Authors: Tags: Immunobiology Source Type: research
Conclusions Repopulation kinetics of the evaluated peripheral lymphocyte subsets did not predict autoimmune AE occurrence or disease activity, including return of disease activity after 2 alemtuzumab courses. Further study is needed to investigate potential antigen-level markers of treatment response.
Source: Neurology Neuroimmunology and Neuroinflammation - Category: Neurology Authors: Tags: MRI, Autoimmune diseases, Clinical trials Randomized controlled (CONSORT agreement), Multiple sclerosis Article Source Type: research
In this study, we analyzed the phenotypic feature of peripheral blood mononuclear cells (PBMCs) in MS patients and found that the patients exhibited an increase in the frequency of B cells, but a markedly decrease in frequency of CD5+ and IL-10+ B cells compared to healthy controls. Infusion of MSCs exhibited a significant therapeutic effect on the experimental autoimmune encephalomyelitis (EAE) mice, infiltration of mononuclear cells and demyelination of the spinal cords were both reduced in CNS of the mice, the frequency of CD5+ IL-10+ B cells in the mice was significantly increased. Additionally, when PBMCs or B cells f...
Source: American Journal of Translational Research - Category: Research Tags: Am J Transl Res Source Type: research
Abstract Progressive multiple sclerosis (PMS) is a devastating disorder sustained by neuroimmune interactions still wait to be identified. Recently, immune-independent, neural bioenergetic derangements have been hypothesized as causative of neurodegeneration in PMS patients. To gather information on the immune and neurodegenerative components during PMS, in the present study we investigated the molecular and cellular events occurring in a Non-obese diabetic (NOD) mouse model of experimental autoimmune encephalomyelitis (EAE). In these mice, we also evaluated the effects of clinically-relevant immunosuppressive (de...
Source: Experimental Neurology - Category: Neurology Authors: Tags: Exp Neurol Source Type: research
ConclusionMS in Kuwait seems to have an earlier age at onset. There is significant gender difference in mental health impairment among patients. Future interventions should be directed toward women, low-income, and non-Kuwaiti-Arabs. The estimated prevalence is based on self-reported data, tertiles as cut-off points, and hence should be interpreted with caution. PDQ and MHI are MSQOLI scales used as screening tools that don't correlate well with an objective test and shouldn't replace objective measures of physical and cognitive function tests including expanded disability status scale or magnetic resonance imaging.
Source: Multiple Sclerosis and Related Disorders - Category: Neurology Source Type: research
More News: Autoimmune Disease | Disability | Multiple Sclerosis | Palliative | Palliative Care | Stem Cell Therapy | Stem Cells | Transplants