Stem cell transplants may slow disability progression in MS

Hematopoietic stem cell transplants may delay disability in people with active secondary progressive multiple sclerosis (MS), according to an Italian study published in Neurology, the medical journal of the American Academy of Neurology.

The ten-year-long, retrospective study included 79 people with active secondary progressive MS who received autologous hematopoietic stem cell transplants and 1,975 people from the Italian MS registry who were treated with MS drugs.

The two groups were matched for age, sex and level of disability. Drugs considered in the study included beta-interferons, azathioprine, glatiramer acetate, mitoxantrone, fingolimod, natalizumab, methotrexate, teriflunomide, cyclophosphamide, dimethyl fumarate and alemtuzumab.

Participants’ level of disability was measured on the Expanded Disability Status Scale (EDSS). At the start of the study, participants had a median score of 6.5, defined as needing to use a cane or brace constantly on both sides to walk about 20m without resting.

Five years into the study, researchers found 62 percent of the participants who had stem cell transplants experienced no worsening of their MS disability, compared to 46 percent of those who took medications.

Additionally, after five years, 19 percent of people that received stem cell transplants experienced less disability than at the start of the study, versus just 4 percent of those taking medications.

Over 10 years, the disability score for people who had stem cell transplants decreased by an average of 0.01 points per year, signifying less disability. In contact the average score for those taking medications increased by 0.16 points per year, suggsting an increase in disability.

“Our study shows that hematopoietic stem cell transplants were associated with a slowing of disability progression and a higher likelihood of disability improvement compared to other therapies,” said Dr Matilde Inglese, author of the study from the University of Genoa in Italy.  

“While these results are encouraging, they are not applicable to patients with secondary progressive MS who do not have signs of inflammatory disease activity,” she added, noting that more research is needed in larger groups of people to confirm the findings.

Limitations of the study were:

• It was retrospective and observational so does not prove cause and effect
• It did not include people taking the MS drugs siponimod, cladribine, ocrelizumab, ofatumumab, or rituximab.

The study was funded by the Italian Multiple Sclerosis Foundation.