Haematopoietic Stem Cell Transplantation for the Treatment of Multiple Sclerosis: Recent Advances.

IF 4.8 2区医学 Q1 CLINICAL NEUROLOGY

Current Neurology and Neuroscience Reports Pub Date : 2023-09-01 DOI:10.1007/s11910-023-01290-2

Alice Mariottini, Eleonora De Matteis, Maria Teresa Cencioni, Paolo A Muraro

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Abstract

Purpose of review: Autologous haematopoietic stem cell transplantation (AHSCT) is increasingly considered a treatment option for patients with multiple sclerosis (MS), an autoimmune demyelinating and degenerative disease of the central nervous system (CNS). AHSCT persistently suppresses inflammation and improves the disease course in large proportions of patients with relapsing-remitting (RR) MS. Aim of this article is to review the relevant new knowledge published during the last 3 years.

Recent findings: Laboratory studies reported confirmatory and new insights into the immunological and biomarker effects of AHSCT. Retrospective clinical studies confirmed excellent outcomes in RRMS, showing possible superior effectiveness over standard therapies and suggesting a possible benefit in early secondary progressive (SP) MS with inflammatory features. New data on risks of infertility and secondary autoimmunity were also reported. Further evidence on the high effectiveness and acceptable safety of AHSCT strengthens its position as a clinical option for aggressive RRMS. Further research is needed to better define its role in treatment-naïve and progressive forms of MS, ideally within randomised clinical trials (RCTs).

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造血干细胞移植治疗多发性硬化:最新进展。

综述目的:自体造血干细胞移植(AHSCT)越来越被认为是多发性硬化症(MS)患者的治疗选择，多发性硬化症是一种自身免疫性脱髓鞘和中枢神经系统(CNS)退行性疾病。在很大比例的复发-缓解(RR) ms患者中，AHSCT持续抑制炎症并改善病程。本文的目的是回顾近3年来发表的相关新知识。最近的发现:实验室研究报道了AHSCT的免疫学和生物标志物效应的证实性和新的见解。回顾性临床研究证实了RRMS的良好结果，显示可能优于标准治疗的有效性，并提示可能对早期继发性进行性(SP) MS有炎症特征。还报道了关于不孕症和继发性自身免疫风险的新数据。进一步的证据表明AHSCT的高有效性和可接受的安全性加强了其作为侵袭性RRMS临床选择的地位。需要进一步的研究来更好地定义其在treatment-naïve和进展型MS中的作用，理想情况下是在随机临床试验(RCTs)中。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Current Neurology and Neuroscience Reports 医学-临床神经学

CiteScore

9.20

自引率

0.00%

发文量

审稿时长

6-12 weeks

期刊介绍： Current Neurology and Neuroscience Reports provides in-depth review articles contributed by international experts on the most significant developments in the field. By presenting clear, insightful, balanced reviews that emphasize recently published papers of major importance, the journal elucidates current and emerging approaches to the diagnosis, treatment, management, and prevention of neurological disease and disorders. Presents the views of experts on current advances in neurology and neuroscience Gathers and synthesizes important recent papers on the topic Includes reviews of recently published clinical trials, valuable web sites, and commentaries from well-known figures in the field.