Autologous Stem Cell Transplant for Multiple Sclerosis
Targeting Multiple Sclerosis as an Autoimmune Disease With Intensive Immunoablative Therapy and Immunological Reconstitution: A Potential Curative Therapy for Patients With a Predicted Poor Prognosis
What it found
A paper reports the results; we have not read it yet. See Papers below.
What was tested
Treatment tested
- immuno-ablation and autologous CD34 selected hematopoietic stem cell transplantation (HSCT),
Compared with
- Standard Therapy
What it measured
Main measures
3 year MS activity free survival
3 year follow-up post transplant
Other measures (4)
Transplant related morbidity
3 year follow-up post transplant
Transplant related mortality
3 years
Time to MS treatment failure
3 years
rate of immune reconstitution following treatment
3 years
Who could take part
MS (type not specified) · 18 to 50
Show the full criteria
Inclusion criteria
* Age between 18 and 50 years * The diagnosis of active multiple sclerosis with relapses or progression and sustained accumulated impairment, made by a neurologist expert in the field * Patient considered at high risk of progression * EDSS Cerebellar Functional score greater than or equal to 3 OR EDSS Pyramidal Functional score greater than or equal to 3 * EDSS between greater than or equal to 3 and less than or equal to 6 * Evidence of current disease activity * Evidence of progression or continued relapses or worsening MRI after at least one year of therapy with interferon-B1, glatiramer acetate, Mitoxantrone, or other conventional dose immunosuppressive drug therapy * If a patient has previously received a cytotoxic agent (Mitoxantrone, Cyclophosphamide etc.) they must have normal bone marrow morphology and cytogenetics before being considered eligible for this study * MRI brain scan that satisfies the MRI criteria of Paty or Fazekas for the diagnosis of multiple sclerosis * No evidence of hepatic inflammation or fibrosis
Exclusion criteria
* Patients with primary progressive multiple sclerosis * Patients with cardiac, renal, pulmonary, hepatic or other organ impairment that would limit their ability to receive dose intensive immunosuppressive therapy including high dose chemotherapy and ASCT * Patient with any active or chronic infection * Patients who are seropositive for HIV1, HIV2, Hepatitis B Surface Antigen, and Hepatitis C * Patients with a previous history of a malignancy other than basal cell carcinoma of the skin or carcinoma in situ that has been in remission for more than one year * Patients whose life expectancy is severely limited by another co-morbid illness * Patients with evidence of myelodysplasia or other non-autoimmune cytopenia * Patients having received a cytotoxic agent within one month of enrolling in this study * Pregnancy or risk of pregnancy. This includes patients that are unwilling to practice active contraception during the time of chemotherapy * Patients with hypersensitivity to rabbit proteins * Patients unable to give written informed consent in accordance with research ethics board guidelines * Patients having previous exposure to natalizumab or alemtuzumab.
As registered. Criteria can change, so ask the trial team or your neurologist.
About this trial
In the sponsor's words
Multiple sclerosis is an autoimmune disease. We are studying whether high dose chemotherapy and autologous stem cell transplant can replace the autoreactive immune system and if this reduces clinical inflammatory disease in the central nervous system (CNS). A second goal is to examine whether there is long-term stabilization or improvement in disability scores if the inflammatory disease is controlled.
Papers
Results
Autologous hematopoietic stem cell transplantation improves fatigue in multiple sclerosis.Mult Scler · 2019
Results
High serum neurofilament light chain normalizes after hematopoietic stem cell transplantation for MS.Neurol Neuroimmunol Neuroinflamm · 2019
Results
Natural Killer Cells Regulate Th17 Cells After Autologous Hematopoietic Stem Cell Transplantation for Relapsing Remitting Multiple Sclerosis.Front Immunol · 2018
Results
Immunoablation and autologous haemopoietic stem-cell transplantation for aggressive multiple sclerosis: a multicentre single-group phase 2 trial.Lancet · 2016
Loading reviews and guidelines…
Related trials
- Therapeutic Monitoring of Drugs Used in the Treatment of Multiple Scle
Phase 4 · Status unknown
No results found
- A phase IV, unicentric, open label clinical trial to evaluate the defa
Phase 4 · Withdrawn
Stopped
- AHSCT With Fludarabine and Cyclophosphamide Based Conditioning Regimes
Phase 1 · Recruiting
Still running
- Relationship Between Oral DMT Burden and Adherence in MS
Status unknown
No results found
- Physical and Cognitive Performance During the Two First Years of Lemtr
Completed
Paper found, not read
- Signatures of Immune Reprogramming in Anti-CD52 Therapy of MS: Markers
Status unknown
Paper found, not read
History
Started
Aug 2001
Main results due
Nov 2012
Finished
Jun 2016