Autologous hematopoietic stem cell transplantation (AHSCT) therapy does not reduce disability or its progression more than natalizumab (Tysabri®) in patients with progressive multiple sclerosis (MS), according to a study presented at the 38th Congress of the European Committee for Treatment and Research in Multiple Sclerosis.

AHSCT is sometimes used to treat patients with progressive MS. To assess whether the approach could slow disease progression better than a disease-modifying therapy such as natalizumab, a team of researchers led by John Snowden, MD, from the Department of Hematology at Sheffield Teaching Hospitals NHS Foundation Trust in the UK, analyzed patients with primary or secondary progressive MS from 6 multinational AHSCT MS centers as well as patients from the international registry MSBase. 

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There were 39 patients treated with AHSCT, of whom 37 had secondary progressive MS. They were matched based on sex, age, disability score, number of relapses, time from disease onset, and most effective prior therapy and country. There were 65 patients treated with natalizumab.

The results showed that the on-treatment relapse frequencies were similar between the 2 groups over up to 6 years. The 6-month worsening or improvement in disability was also similar. 

In patients treated with AHSCT, 3 had febrile neutropenia during mobilization, 9 had serum sickness, 6 needed to be admitted to the intensive care unit, and 36 had complications following discharge, which included 21 infectious complications. There were no treatment-related deaths.

“Among patients with progressive MS, advanced disability, and low pre-treatment relapse activity, enriched with patients with recent disability progression, AHSCT is not superior in reducing disability progression or allowing reduction of disability than natalizumab,” the researchers concluded.

Reference

Kalincik T, Sharmin S, Roos I, et al. Effectiveness of autologous haematopoietic stem cell transplantation in comparison with natalizumab in progressive MS. Presented at: Congress of the European Committee for Treatment and Research in Multiple Sclerosis; October 26-28, 2022; Amsterdam, the Netherlands.