Safety and efficacy of autologous hematopoietic stem cell transplantation for multiple sclerosis in Norway

Mult Scler. 2020 Dec;26(14):1889-1897. doi: 10.1177/1352458519893926. Epub 2019 Dec 13.

Abstract

Background: Hematopoietic stem cell treatment (HSCT) is a promising treatment option for multiple sclerosis (MS), but detailed safety and efficacy measures are still scarce.

Objective: To evaluate the efficacy and safety of HSCT in MS.

Methods: Retrospective single-center observational study of all MS patients that underwent HSCT in Norway during January 2015 to January 2018. The primary outcome was no evidence of disease activity (NEDA-3) status.

Results: A total of 30 patients with a median follow-up time of 26 months (range: 11-48) were evaluated. In total, 25 (83%) achieved NEDA-3 status, and none received disease-modifying treatment after HSCT. For 13 (43%) of the patients, there were sustained improvement in Expanded Disability Status Scale (EDSS) score, and 10 (33%) were working full time after the treatment, compared to only 1 (3%) before treatment. There were no serious treatment-related complications and was no mortality. Five patients (17%) were diagnosed with an autoimmune thyroid disease after the procedure, and 10 (43%) of the women had amenorrhea lasting >12 months and symptoms of ovarian failure.

Conclusion: HSCT in MS is an effective and relatively safe treatment option, with few serious complications and no mortality in Norway, so far. However, long-term adverse event with amenorrhea is a common problem.

Keywords: Multiple sclerosis; hematopoietic stem cell treatment; no evidence of disease activity status; relapsing remitting.

Publication types

  • Observational Study

MeSH terms

  • Disability Evaluation
  • Female
  • Hematopoietic Stem Cell Transplantation* / adverse effects
  • Humans
  • Multiple Sclerosis* / therapy
  • Multiple Sclerosis, Relapsing-Remitting*
  • Retrospective Studies
  • Transplantation, Autologous
  • Treatment Outcome