HSCT Vs DMT For Prolonged RRMS Progression

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HSCT Vs DMT For Prolonged RRMS Progression - A Clinical Report

Dr. Richard Burt

· Physical therapy

Dr. Richard Burt is a professor of medicine at Feinberg School of Medicine, Northwestern University, Chicago. Dr. Richard Burt has written medical papers on bone marrow transplantation, autoimmune disorder treatment, and stem cell therapy. He also has conducted studies on multiple sclerosis, with more than fifteen publications on treating the disease, including the first randomized trial of HSC transplantation for multiple sclerosis titled: "Effect of Nonmyeloablative Hematopoietic Stem Cell Transplantation vs Continued Disease-Modifying Therapy on Disease Progression in Patients With Relapsing-Remitting Multiple Sclerosis." that was published in JAMA in 2019

Occurring in different types, multiple sclerosis is a neurological condition characterized by damage to the protective sheath that covers nerve fibers by an unstable immune system, leading to communication problems between brain cells. It can cause permanent disability of affected nerves.

Relapsing-remitting multiple sclerosis, the most common form of MS, happens when a patient experiences periodic attacks separated by stable periods. During a relapse, patients may notice urinary urgency, tingling sensation or numbness, visual loss, double vision, paralysis of limbs, and fatigue. Various treatments are available for RRMS, including medications to help relieve symptoms, physical therapy, disease-modifying therapies (DMT), which are medicines designed to limit the number of relapses.

The study compared the difference in efficacy of DMT and Hematopoietic Stem Cell Transplant (HSCT), which involves the intravenous infusion of stem cells to help in restoring the immune system. The study evaluated 110 RRMS patients who had received treatment between September 20, 2005, and July 7, 2016, at different centers, following previous DMT treatments. From the data, a group of patients was randomized to receive higher efficacy or a different class of DMTs, and another group had HSCT using a low intensity non-myeloablative conditioning regimen of cyclophosphamide and ATG.. A lower percentage of patients from the HSCT group had RRMS neurologic progression of disability as compared to the DMT group. The patients that received HSCT also had reversal of neurological disability while those on continued DMT worsened which led to the conclusion that HSCT is superior to DMT for prolonged progression of the disease.