Stem-Cell Transplantation Therapy Beneficial Among Patients With MS

Autologous hematopoietic stem-cell transplantation is highly effective at preventing multiple sclerosis (MS) progression and relapse, according to findings published in Neurology and Therapy.

“Current data encourage a broader application of autologous hematopoietic stem-cell transplantation for treating patients with MS while still considering proper patient selection and transplant methods,” wrote researchers.

The systematic review and meta-analysis into the efficacy and safety of autologous hematopoietic stem-cell transplantation included 50 studies with a total of 4831 patients with MS.

According to study authors, autologous hematopoietic stem-cell transplantation significantly improved both primary outcome measures the study used to gauge the treatment’s efficacy: the Expanded Disability Status Scale (EDSS) score and annualized relapse rate.

Compared with before autologous hematopoietic stem-cell transplantation, the average EDSS score decreased 0.48, and the annualized relapse rate decreased 1.58 after treatment. Additionally, pooled estimates after treatment were 73% for progression-free survival, 81% for relapse-free survival, and 63% for event-free survival.

Improvements in magnetic resonance imaging (MRI) activity-free survival and incidence of new MRI lesions after treatment were slight but not significant, reported researchers.

MRI activity-free survival was 89%, and new MRI lesions appeared in about 8% of patients after autologous hematopoietic stem-cell transplantation. Some 68% of patients experienced no evidence of disease activity after autologous hematopoietic stem-cell transplantation.

Overall survival after autologous hematopoietic stem-cell transplantation was 94%; 4% of patients died from causes related to the transplant.

“The relatively high transplant-related mortality of autologous hematopoietic stem-cell transplantation versus other disease-modifying therapies may be linked with patient characteristics,” wrote researchers. “For instance, patients receiving autologous hematopoietic stem-cell transplantation tend to have a more aggressive course of disease. Also, all autologous hematopoietic stem-cell transplantation patients need to be protected from vaccine-preventable diseases, and the emergence of the COVID-19 pandemic has complicated this procedure in recent years.”

“Thus, the need for studies investigating the efficacy and safety of earlier autologous hematopoietic stem-cell transplantation administration as mentioned in the European Society for Blood and Marrow Transplantation criteria has increased,” concluded researchers.

Reference:
Nabizadeh F, Pirahesh K, Rafiei N, et al. Autologous hematopoietic stem-cell transplantation in multiple sclerosis: a systematic review and meta-analysis. Neurol Ther. Published online July 28, 2022. doi: 10.1007/s40120-022-00389-x