HSCT in MS: More a remission than a cure says respected neuro

[ActiveMSers]

This new take by neuro Dr. Gnanapavan (who contributes to the Barts MS Blog) is pretty insightful. -D

In a prose to seduce the weary palate, the British neurologist, I recollect saying: “What should be the aims of HSCT treatment? At worst, remission. At best, a cure“.

I may just have to eat my words....

My earlier enthusiasm towards HSCT somewhat deflated, I am in other ways strangely buoyed by the knowledge that clinicians are now starting to ask the right questions about treatment efficacy in MS. I eagerly await further data on HSCT and its comparative treatments.

https://multiple-sclerosis-research....n-than-a-cure/

[ActiveMSers]

Here is his earlier HSCT post, which was a tad more positive. -D

But, if you are in that lucky 30% that achieve a cure with this treatment, then who am I to argue with the facts?

https://multiple-sclerosis-research....a-cure-for-ms/

[ActiveMSers]

I appears oligoclonal banding (OCB) in the CSF is the catch. If it doesn't go away, your MS is almost certainly going to return.

OCB status in MS is very important, and furthermore ridding the body of OCBs, even more so.

So, what is the effect of HSCT on OCB status?

At >1500 day follow-up (~49 months or 4 years), in the 45 participants studied, 98% were OCB positive prior to HSCT. However, 74% remained positive afterwards....

In my opinion, this rate of elimination of the underlying autoimmunity is insufficient to declare HSCT a success, in so far as a cure is concerned. ... This indicates that HSCT has a greater chance of achieving long-term remission in selected individuals, than a cure.

I expect more long-term studies will bear this conclusion out. HSCT is still devastatingly effective for the right patient, but the adage that nothing lasts forever likely holds true for this treatment as well....