Hematopoietic Stem Cell Transplantation in Multiple Sclerosis

Introduction and Objective: Multiple sclerosis (MS) is a chronic, inflammatory, demyelinating, and autoimmune disease of the central nervous system (CNS). Current treatments for MS are immunosuppressive to reduce the frequency and intensity of relapses. Recent studies have shown that cellular therapies can repair neurons and prevent inflammatory damage.Method: This brief review was done by a systematic search across PubMed, Google Scholar, and the National Institute for Neurological Disorders and Stroke (NINDS) from ۲۰۱۷ to ۲۰۲۲.Results: Hematopoietic stem cells can produce all the different cells, such as immune cells. As HSCT removes harmful cells and resets the immune system, it helps rebuild immunity. It's most effective for people who have relapsing and remitting MS, are under ۵۰ years of age, and have had MS for less than ۱۰ years, as measured by the Expanded Disability Status Scale (EDSS). Patients with active relapsing MS treated with HSCT had no relapses for one year in a randomized control trial. There were ۳۹ relapses after drug treatments. ۹۴% of people treated with HSCT didn’t see their disability get worse for ۳ years. EDSS scores improved for them. For those on drug treatments, average EDSS scores got worse. For progressive MS, studies have shown encouraging results, but there are still signs of inflammation. HSCT is among the highest risks of side effects, especially serious ones, such as developing infections and cancers, early menopause, and fertility problems. Chemotherapy - part of the HSCT procedure - has side effects like bleeding and bruising, fatigue, loss of appetite, and hair loss. In cases of high disability, chemotherapy can be more harmful. Since ۲۰۰۵, ۱ person has died in every ۳۳۰ cases. This risk can increase under certain conditions.Conclusion: To perform autologous HSCT, an expert hematologist is needed, as well as extreme precautions against infection. Safety of the procedure is a major concern. According to various studies, more than ۱۰۰۰ cases of MS have been treated with autologous hematopoietic stem cell transplantation since ۱۹۹۵.

کلیدواژه ها:

Autologous Hematopoietic Stem Cells ، Multiple Sclerosis ، Cellular Therapy