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Autologous Bone Marrow Transplantation for the Treatment of Multiple Sclerosis
Authors:Marta Radaelli  Arianna Merlini  Raffaella Greco  Francesca Sangalli  Giancarlo Comi  Fabio Ciceri  Gianvito Martino
Institution:1. Department of Neurology, Vita Salute San Raffaele University, San Raffaele Scientific Institute, Milan, Italy
2. Neuroimmunology Unit, Institute of Experimental Neurology (INSpe) , Division of Neuroscience, San Raffaele Scientific Institute, Via Olgettina 58, 20132, Milan, Italy
3. Hematology and Bone Marrow Transplantation Unit, San Raffaele Scientific Institute, Milan, Italy
Abstract:Multiple sclerosis (MS) is a chronic inflammatory disease of the central nervous system and represents one of the leading causes of neurologic disability in young adults. Current treatments for MS have shown limited efficacy in patients with either a progressive or an aggressive disease course. Hematopoietic stem cell transplantation (HSCT) has been proposed to control or even cure refractory cases of MS. Indeed, HSCT is able to temporarily eradicate the autoreactive cells and to reset the aberrant immune response to self-antigens. In the last decade, owing to the growing experience in selecting the most appropriate patients to transplant and the recent advances in chemotherapeutic and support regimens, the transplant-related mortality of autologous HSCT in MS patients dropped down to 1,3 % and the progression-free survival ranges from 47 % to 100 %. Altogether, these data support autologous HSCT as a possible second-line therapy for refractory MS.
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