Jan Hillert, MD, PhD, professor and senior physician in the department of clinical neuroscience, Karolinska Institutet, Stockholm, Sweden, discusses the body of knowledge on using stem cell transplants to treat patients with multiple sclerosis (MS).
Jan Hillert, MD, PhD, professor and senior physician in the department of clinical neuroscience, Karolinska Institutet, Stockholm, Sweden, discusses the body of knowledge on using stem cell transplants to treat patients with multiple sclerosis (MS).
Transcript
What is the current state of knowledge about using stem cell transplants in patients with MS?
There is an increasing body of evidence indicating that the effectiveness of such procedures is very good. The proportion of patients having gone through such a procedure having no evidence of disease activity, what we can NEDA, is unparalleled by other ways of treating MS. So for sure, this is a very efficient way of stopping the relapsing form of MS.
Whether it also prevents the progressive phase, which comes long after, we don’t know yet. We know that if we do the transplants when the patient is already in the progressive phase, then the progression carries on, so we need to do it early.
The remaining issue which prevents this from being very, very widespread is of course the safety side. It looks really promising. In some of the regiments, some of the ways in which to do this, there have been very few side effects and practically no mortality. Whereas in some of the other ways of doing it, there are still people dying from the procedure itself. So we need to ensure, of course, if we launch this as a treatment for a big proportion of MS patients, that it’s really safe.
Then the question ethically becomes, what kind of mortality can we accept? It needs to be way below a percent, of course. So that’s why there is still hesitation, I would say. But the efficacy or effectiveness evidence, they look just fantastic.
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