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Old 05-22-2018, 12:04 PM
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Dave @ ActiveMSers
Join Date: Jun 2008
Location: Albuquerque, NM
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Default What is HSCT? An excellent overview

MS researcher Gavin Giovannoni just posted this blog on his Barts MS website. A good read. - D

HSCT = hematopoietic stem cell transplant

HSCT is simply a rebranding of bone marrow transplantation or BMT. BMT was the term we used when the stem cells had to be harvested by doing a bone marrow aspirates, i.e. a thick needle was inserted into the bone and the marrow sucked out under pressure. This procedure is painful and is done under sedation. I remember it very well when I was a houseman and junior medical registrar, or trainee, I worked on a haem-oncology unit and had to do this procedure. Fortunately, the haematologists have now developed an effective way of mobilising and harvesting stem cells from the blood without having to tap the bone marrow. This is done by giving a small dose of chemotherapy followed by growth factors so that the stem cells spillover from the bone marrow into the blood. These stem cells are harvested and frozen and can then be given after immunoablation therapy. Immunoablation therapy refers to chemotherapy to get rid of your immune cells.

Please note that all that these stem cells do is allow you to receive more potent chemotherapy and work by allowing your bone marrow to recover more quickly. There is nothing magic about this; HSCT in the treatment of MS is simply used to speed up bone marrow recovery, nothing more and nothing less. More rapid bone marrow recovery makes BMT safer.

The stem cells in HSCT don't go to the brain and spinal cord to repair the damage. This is a common misperception. People think the haemopoietic stem cells are being given to repair the damage that has accrued from having MS. This is why HSCT, like other DMTs, is more effective when used early before MS causes too much damage.

There are different intensities of bone marrow ablation therapy. So-called myeloablative therapy is aimed ....

Dave Bexfield
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