No Evidence of Disease Activity after Five Years of Autologous Hematopoietic Stem Cell Therapy for Multiple Sclerosis: Detailed Report of Five Patients

Background:: Multiple sclerosis (MS) is an immune-mediated disease of the central nervous system. Its treatment has focused on inflammation control as early as possible to avoid disability. Autologous hematopoietic stem cell transplantation (AHSCT) has been used for treating MS since 1996 without decisive results regarding benefits or long-term efficacy. We report the follow-up of five patients who were evaluated for up to five years after the stem cell transplantation treatment and who did not present any disease activity. Methods: Five patients followed up at an MS center in Belo Horizonte, Brazil, who had relapsing-remitting MS with high disease activity, underwent AHSCT from 2009 to 2011. They were evaluated clinically, with magnetic resonance imaging, and by the Expanded Disability Status Scale, every six months and up to five years after transplantation. Results: The patients in our study comprised four women and one man, with age ranging from 25 to 50 years, and time since disease onset ranging from 4 to 17 years at the time of the procedure. Four patients improved, one patient was stabilized, and all patients continued to be free of disease activity after 5 years. Discussion:: Through improving patient selection and decreasing the time since disease onset, AHSCT could stop epitope spreading and disease progression. Despite multiple other therapeutic choices, AHSCT is a treatment to consider for aggressive MS disease.