High dose immunosuppressive therapy with autologous hematopoietic stem cell transplantation in patients with progressive and relapsing-remitting types of multiple sclerosis: clinical response and quality of life

The goal of treatment of MS is to halt MS progression and to improve a patient’s quality of life (QoL). High-dose immunosuppressive therapy (HDIT) with autologous haematopoietic stem cell transplantation (AHSCT) is a new and promising approach to MS treatment. In order to evaluate the efficacy of treatment or rehabilitation of MS patients it is necessary to assess not only the clinical data (MRI, EDSS) but also patients’ QoL. In this paper we present the results of clinical and QoL monitoring in 93 patients with different types MS after AHSCT. QoL was assessed using RAND SF-36. The mobilization and transplantation procedures were well tolerated. At long-term follow-up (mean 47,2 months), the overall clinical response in terms of disease improvement or stabilization was 95% in patients with relapsing-remitting MS and in 77,5% of patients with progressive MS. No active, new, or enlarging lesions in magnetic resonance imaging were registered in patients without disease progression. All patients who did not have disease progression were off therapy throughout the post-transplantation period. Significant impairment of QoL was observed at base-line. After HDIT+AHSCT dramatic improvement of QoL was registered. The results of our study support the feasibility of AHSCT in MS patients and complex approach for treatment efficacy assessment in this group of patients.