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Outcomes and Cost-Effectiveness of Autologous Hematopoietic Cell Transplant for MS

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  • Outcomes and Cost-Effectiveness of Autologous Hematopoietic Cell Transplant for MS

    Current Treatment Options in Neurology

    Outcomes and Cost-Effectiveness of Autologous Hematopoietic Cell Transplant for Multiple Sclerosis

    Authors
    Anastasie M. Dunn-Pirio, Benjamin M. Heyman, et al

    First Online: 17 October 2019

    Abstract

    Purpose of review
    This review presents a critical appraisal of the use of autologous hematopoietic cell transplant (AHCT) for the treatment of multiple sclerosis. We present the reader with a brief review on the AHCT procedure, its immunomodulatory mechanism of action in MS, the most recent evidence in support of its use in patients with relapsing-remitting multiple sclerosis (RRMS), as well as its cost considerations.

    Recent findings
    The first meta-analysis of clinical trials of AHCT for patients with MS demonstrated durable 5-year progression-free survival rates and low treatment-related mortality. Recently, the first randomized controlled phase III clinical trial demonstrated AHCT to be superior to best available therapy for a subset of patients with RRMS. This led to the American society for transplant and cellular therapies (ASTCT) to recommend AHCT “for patients with relapsing forms of MS who have prognostic factors that indicate a high risk of future disability.”

    Summary
    AHCT should be considered for patients with RRMS with evidence of clinical activity who have failed 2 lines of therapy or at least one highly active disease-modifying therapy.
    Dave Bexfield
    ActiveMSers
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