Photo: Inflammation and stem cells

7 things you need to know about HSCT

After the BBC Panorama documentary ‘Can You Stop My Multiple Sclerosis', our research team put together some facts about autologous haematopoietic stem cell transplantation (HSCT).

1. What does HSCT mean?

HSCT (sometimes referred to as AHSCT) stands for autologous haematopoietic stem cell transplantation. Haematopoietic refers to the type of stem cells used in the treatment which are found in the bone marrow and blood. Autologous means ‘from the same place’ as the stem cells used in the procedure are the person’s own.

2. What happens in HSCT?

It’s a one-off procedure involving taking haematopoietic stem cells from your bone marrow or blood, wiping out your immune system with chemotherapy and then reintroducing them to your body.

3. How does it work?

The aim of HSCT is to reset the immune system to stop it from attacking the central nervous system. It doesn’t rebuild damaged nerves - these aren’t the kind of stem cells you may have heard about in relation to building organs in a laboratory for example.

4. Is it effective?

It has been an effective treatment for SOME people with MS. The best results so far have been seen in people with highly active forms of relapsing MS but so far it doesn’t look to be effective for progressive MS because it can’t repair damage already done.

5. What are the risks?

It has a higher risk than current MS therapies, carrying a 1.3% mortality rate. This means one to two people die from the treatment for every 100 people who receive it.

6. Who can perform HSCT?

Any centre performing transplantations, for MS or any other condition, should have a Joint Accreditation Committee-ISCT and EBMT (JACIE) licence. You must be referred to somewhere carrying out HSCT for MS through a health care professional.

7. What does the research tell us?

A number of clinical trials have shown HSCT can reduce relapses and stabilise or improve disability in people with relapsing remitting MS. An international clinical trial of HSCT, called the MIST trial, is currently ongoing with a centre in the UK participating.

Ultimately, we need more studies to understand the long term effects of HSCT. So far, the longest follow up study to date revisited people who had received the transplant an average of 6.6 years later.