High-Dose Immunosuppressive Therapy with Autologous Hematopoietic Stem Cell Transplantation
(HDIT with AHSCT)
AHSCT is a type of transplantation that uses the person's own stem cells particularly from peripheral blood.
These cells are collected in advance, stored at sub-zero temperatures, and returned at a later stage, after high dose chemotherapy or immunosupressive therapy.
This approach can stop the progression of the disease in most patients and prevent further decrease of their quality of life.
What is Autologous Hematopoietic Stem Cell Transplantation?
This is an established treatment for more than 3 decades and clinically approved for hematological malignancies (such as lymphoma, leukemia).
Due to haemopoietic stem cell transplantation, the majority of the patients suffering from tumor blood diseases, who earlier were condemned to rapid death, obtained significant chances for recovery.
As fundamental investigations have shown, the cause for development of autoimmune diseases is impairment of the cells of the immune system.
Therapy is clinically approved
Autologous hematopoietic stem cell transplantation has nothing to do with the so called "cell therapy" approaches that are popular in Russia nowadays.
Multiple sclerosis patients do not need any maintenance therapy after transplantation.
It was shown that transplantation procedure was well tolerated by the patients.
The core results of this study are presented below.
Do not need any maintenance therapy after transplantation
This procedure intends to eradicate autoreactive immune cells in patient's body, which destroy healthy tissues of the patients and may lead to development of autoimmune diseases.
Chemotherapy dose for this procedure is less than in the established protocol for patients who have lymphoma or leukemia. The use of less intensive conditioning regimens is supported by the suggestion that AHSCT is not only immunosuppressive therapy, but also may have immunomodulation component.
Moderate intensity and less toxic regimen may induce durable long-term remission, comparable with the high intensity regimens, but without being associated with the higher transplant-related mortality.
We suggest, that the best candidates for transplantation are relatively young patients with active inflammatory lesions of relatively short duration and rapidly progressive disease, but still low disability scores, resistant to conventional therapy.
Cumulative incidence of disease progression was quite low both for Relapsing-Remitting Multiple Sclerosis (RRMS) and Progressive Multiple Sclerosis (PrMS). It was higher in patients with progressive course of the disease than in those with relapsing-remitting MS: 21.3% vs 13.2%
For long-term follow-up (median 48.9 months), in the group with RRMS event-free survival rate was 83.3% and in the group with progressive course – 75.5%.
IMPROVEMENT AT LONG-TERM FOLLOW-UP
Effective for patients in both groups with relapsing-remitting, and for patients with progressive (primary and secondary) courses of the disease.