Haematopoietic stem cell transplantation (HSCT)

Written and reviewed by Dr Ibrahim Imam, Consultant Neurologist. Last reviewed .

Haematopoietic stem cell transplantation (HSCT). HSCT resets the immune system. Fully referenced neurology checklist.

Benefits

  • HSCT resets the immune system
  • About 70-80% of recipients are stabilised for 3-5 years
  • The 10-year remission is about 70%
  • It improves the quality of life
  • It also improves functional scores
  • It may be more effective than other immunosuppressive treatments

Indications

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Pre-procedure treatments

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HSC harvesting

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Conditioning chemotherapy options

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Infection-related side effects

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Other side effects

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Outcome

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Predictors of good outcome

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References

  1. Rogojan C, Frederiksen JL. Hematopoietic stem cell transplantation in multiple sclerosis. Acta Neurol Scand 2009; 120:371-382.
  2. Burman J, Iacobaeus E, Svenningsson A, et al. Autologous haematopoietic stem cell transplantation for aggressive multiple sclerosis: the Swedish experience. JNNP 2014; 85:1116-1121.
  3. Nash RA, Hutton GJ, Racke MK, et al. High-dose immunosuppressive therapy and autologous hematopoietic cell transplantation for relapsing-remitting multiple sclerosis (HALT-MS)A 3-year interim report. JAMA Neurol 2015; 72:159-169. 
  4. Muraro PA, Martin R, Mancardi GL, Nicholas R, Sormani MP, Saccardi R. Autologous haematopoietic stem cell transplantation for treatment of multiple sclerosis. Nat Rev Neurol 2017; 13:391-405.
  5. Boffa G, Massacesi L, Inglese M, et al. Long-term clinical outcomes of hematopoietic stem cell transplantation in multiple sclerosis. Neurology 2021 (Online ahead of print).
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