ActiveMSers Forums  

Go Back   ActiveMSers Forums > ActiveMSers.org Forums > Dave's SCT Journey

Reply
 
Thread Tools Display Modes
  #1  
Old 12-18-2018, 03:19 PM
ActiveMSers's Avatar
ActiveMSers ActiveMSers is online now
Dave @ ActiveMSers
 
Join Date: Jun 2008
Location: Albuquerque, NM
Posts: 3,560
Default Efficacy and safety of aHSCT in MS, a systematic review and meta-analysis

Neurological Sciences

Efficacy and safety of autologous hematopoietic stem-cell transplantation in multiple sclerosis: a systematic review and meta-analysis

Authors

Fangfang GeHong LinZhuyi LiTing Chang

First Online: 10 December 2018

Abstract

Background
Autologous hematopoietic stem-cell transplantation (AHSCT) has been utilized as a treatment option for multiple sclerosis (MS) since 1995. However, this procedure has not been widely implemented in clinical practice owing to its mortality risk. Here, we conduct a meta-analysis to evaluate the long-term efficacy and safety of AHSCT in MS treatment, aiming to optimize the benefit/risk ratio of this therapeutic strategy.

Methods
We searched the PubMed Web site and clinicaltrials.gov databases. The efficacy endpoints were progression-free survival (PFS) and disease activity-free survival. The safety outcomes were transplant-related mortality (TRM) and overall deaths.

Results
Eighteen eligible studies with a total of 732 participants were enrolled. The PFS was 75% (95% CI, 0.69–0.81), and the estimate of disease activity-free survival was 61% with 48-month follow-up. Subgroups analysis showed that low- and intermediate-intensity regimens were associated with higher PFS 80%. Relapsing remitting MS (RRMS) benefited more from AHSCT than other MS subtypes with PFS 85%. Patients with Gd+ lesions at baseline MRI responded better to AHSCT with PFS 77%. The estimate of TRM was 1.34% (95% CI, 0.39–2.30), and the overall mortality was 3.58%. TRM was significantly higher in high-intensity regimen studies (3.13%) and in older studies (1.93%) performed before 2006.

Conclusions
This meta-analysis provides evidences that AHSCT can induce long-term remissions for MS patients with a high degree of safety. We indicate low- and intermediate-intensity regimens and RRMS patients with the presence of Gd+ lesions at baseline MRI can obtain the optimal benefit/risk ratio from AHSCT.
__________________
Dave Bexfield
ActiveMSers
Reply With Quote
Reply

Thread Tools
Display Modes

Posting Rules
You may not post new threads
You may not post replies
You may not post attachments
You may not edit your posts

BB code is On
Smilies are On
[IMG] code is On
HTML code is Off
Forum Jump


All times are GMT -4. The time now is 12:14 AM.


Powered by vBulletin® Version 3.7.0
Copyright ©2000 - 2019, Jelsoft Enterprises Ltd.
ActiveMSers