1. Autologous haematopoietic stem cell transplantation and other cellular therapy in multiple sclerosis and immune-mediated neurological diseases
- Author
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Sharrack, B., Saccardi, R., Alexander, T., Badoglio, M., Burman, J., Farge, D., Greco, R., Jessop, H., Kazmi, M., Kirgizov, K., Labopin, M., Mancardi, G., Martin, R., Moore, J., Muraro, P.A., Rovira Tarrats, Montserrat, Sormani, M.P., Snowden, J.A., Snowden, J., McGrath, E., Bambi, F., Sanchez-Guijo, F., Worel, N., Badolglio, M., Abinun, M., Arnold, R., Brierley, C., Castilla-Llorente, C., Cooper, N., Daikeler, T., del Papa, N., Finke, J., Hagglund, H., Henes, J., Hiepe, F., Kiely, D., Marjanovic, Z., Martin, T., Ma, D., Miller, P., Muraro, P., Oliveira, M.C., Polushin, A., Onida, F., Simoes, B., Puyade, M., Resnick, I., Rovira, Montserrat, Saif, M., Sakellari, I., Snarski, E., Scherer, H.U., Sossa, C., de Vries-Bouwstra, J., Wulffraat, N., Zaccara, E., Universitat Autònoma de Barcelona, University of Zurich, and Snowden, John A
- Subjects
Feature ,medicine.medical_specialty ,Multiple Sclerosis ,Neurologi ,Bone marrow transplantation ,2747 Transplantation ,medicine.medical_treatment ,Immunology ,2720 Hematology ,Chronic inflammatory demyelinating polyneuropathy ,610 Medicine & health ,Disease ,Hematopoietic stem cell transplantation ,Transplantation, Autologous ,Accreditation ,Autoimmune Diseases ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,medicine ,Humans ,European Society for Blood and Marrow Transplantation (EBMT) Autoimmune Diseases Working Party (ADWP) and the Joint Accreditation Committee of the International Society for Cellular Therapy (ISCT) and EBMT (JACIE) ,Intensive care medicine ,Peripheral neuropathies ,Transplantation ,Hematology ,Neuromyelitis optica ,business.industry ,Multiple sclerosis ,Hematopoietic Stem Cell Transplantation ,1103 Clinical Sciences ,medicine.disease ,10040 Clinic for Neurology ,Clinical trial ,Europe ,surgical procedures, operative ,Neurology ,business ,030217 neurology & neurosurgery ,030215 immunology - Abstract
These updated EBMT guidelines review the clinical evidence, registry activity and mechanisms of action of haematopoietic stem cell transplantation (HSCT) in multiple sclerosis (MS) and other immune-mediated neurological diseases and provide recommendations for patient selection, transplant technique, follow-up and future development. The major focus is on autologous HSCT (aHSCT), used in MS for over two decades and currently the fastest growing indication for this treatment in Europe, with increasing evidence to support its use in highly active relapsing remitting MS failing to respond to disease modifying therapies. aHSCT may have a potential role in the treatment of the progressive forms of MS with a significant inflammatory component and other immune-mediated neurological diseases, including chronic inflammatory demyelinating polyneuropathy, neuromyelitis optica, myasthenia gravis and stiff person syndrome. Allogeneic HSCT should only be considered where potential risks are justified. Compared with other immunomodulatory treatments, HSCT is associated with greater short-term risks and requires close interspeciality collaboration between transplant physicians and neurologists with a special interest in these neurological conditions before, during and after treatment in accredited HSCT centres. Other experimental cell therapies are developmental for these diseases and patients should only be treated on clinical trials.
- Published
- 2020