An international study of stem cell transplant has shown haematopoietic stem cell transplantation is effective and safe for people with highly active relapsing multiple sclerosis. The MIST trial showed haematopoietic stem cell transplantation can stabilise relapsing multiple sclerosis and improve disability in people who were previously experiencing relapses while on disease modifying therapies (DMTs).The results have been hailed as “hugely encouraging” by researchers Professor Basil Sharrack and Professor John Snowden, who led the UK arm of the trial at Sheffield’s Royal Hallamshire Hospital: “Almost all patients receiving autologous haematopoietic stem cell transplantation showed no signs of their disease being active a year on from having the treatment. And more importantly, their level of disability improved significantly.”
110 people who’d had at least two relapses in the past year while on a DMT were recruited for the stem cell transplant study. Half underwent the stem cell transplant and the other half took the DMTs as recommended by their neurologist. Researchers looked at the number of relapses and the progression of disability of multiple sclerosis. Only one person who had the transplant suffered a relapse, compared to 39 relapses in people taking drug treatments. If people continued to have relapses on a DMT they could switch to the transplant arm of the trial. 30 people switched, and their condition improved.
Results were presented at the Annual Meeting of the European Society for Blood and Marrow Transplantation. Next the stem cell transplant results need to be published in a peer reviewed journal. The MS Society Director of Research, Dr Susan Kohlhaas, advised we still need learn more: “The MIST results are important and show this area needs further research. While haematopoietic stem cell transplantation appears to be effective for some people with MS, it remains a high-risk treatment that won’t be right for everyone. We now need to know how haematopoietic stem cell transplantation compares to existing, less aggressive, multiple sclerosis treatment options.”
Making sure haematopoietic stem cell transplantation is accessible should be prioritised. Susan said: “HSCT will soon be recognised as an established treatment in England. And when that happens our priority will be making sure those who could benefit can actually get it. We’ve seen life changing results for some people and having that opportunity can’t depend on your postcode.”
Dr Paulo Bittencourt
Copied and adapted from the site of MS Society on 18.03.2018
Details of study
https://clinicaltrials.gov/ct2/show/NCT00273364?term=NCT00273364&rank=1
