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Study from Italy Suggests Some People with Active Secondary Progressive MS May Benefit from Bone Marrow Transplants

December 21, 2022

An observational study by investigators in Italy compared the outcomes for people with active secondary progressive MS who were treated with either standard MS disease modifying therapies or bone marrow transplant (aHSCT, short for Autologous Hematopoietic Stem Cell Transplantation). In a study published in the journal Neurology, they report that aHSCT may delay progression of disability longer than some MS medications.
  • Background:
    • Secondary progressive MS follows an initial relapsing-remitting course. Some people with relapsing-remitting MS eventually transition to a secondary progressive course involving progressive worsening and accumulation of disability over time. “Active” secondary progressive MS refers to people who continue to experience relapses or new activity detected on brain MRI scans.
    • aHSCT: Previous studies and clinical trials have suggested that aHSCT is most beneficial for people who have very aggressive relapsing-remitting MS who have not benefitted from disease modifying therapies.
  • This Study: The team looked back over ten years at records of 79 people with active secondary progressive MS who received aHSCT and compared their progression to that of 1,975 people from the Italian MS registry who were treated with various MS therapies and who were of similar age (average age of 39) and disability levels (EDSS scores of 6.5, needing canes on both sides to walk). All received their treatment after being diagnosed with active secondary progressive MS.
  • Results: The investigators reported that over 5 years, those who underwent aHSCT experienced slower progression of disability compared to those on the disease-modifying therapies. More people in the aHSCT group stabilized and did not worsen over 5 years, and some showed some improvement.
  • Meaning: This study adds to information about who may benefit from aHSCT and suggests that some people with active secondary progressive MS may benefit.
    • The investigators point out that this was an observational study (rather than a controlled clinical trial), so the outcomes need confirmation
    • They also note that in this study aHSCT was not compared to the most powerful MS therapies that are now available. Trials comparing aHSCT to the best available therapies are now underway.
  • The study was funded by the Italian Multiple Sclerosis Foundation.
Learn more about Autologous Hematopoietic Stem Cell Transplantation for MS
Hematopoietic Stem Cell Transplantation in People With Active Secondary Progressive Multiple Sclerosis,” by Giacomo Boffa, Alessio Signori, Luca Massacesi, and others, with senior author Matilde Inglese, on behalf of Italian BMT-MS Study Group, Italian MS Register, was published early online on December 21, 2022 in Neurology, the journal of the American Academy of Neurology.

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Multiple sclerosis is an unpredictable disease of the central nervous system. Currently there is no cure. Symptoms vary from person to person and may include disabling fatigue, mobility challenges, cognitive changes, and vision issues. An estimated 1 million people live with MS in the United States. Early diagnosis and treatment are critical to minimize disability. Significant progress is being made to achieve a world free of MS.

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