Autologous haematopoietic stem cell transplant (AHSCT)
Autologous haematopoietic stem cell transplant (AHSCT) is an immune suppressing chemotherapy treatment combined with reinfusion of blood stem cells to rebuild the immune system. Whilst AHSCT may be able to stabilise or improve disability in some people with MS, MS is a disease with a varied outcome affecting each individual differently and therefore this treatment is not suitable for all people nor all types of MS. It is an aggressive treatment with considerable risks.
As an experimental treatment, Australian hospitals and doctors are only likely to recommend AHSCT for an individual with MS if the other approved MS therapies are not working or cannot be used in this person for other reasons.
Currently, the treatment is provided in Australia through three observational clinical trials, at St Vincent’s Hospital, Sydney, Austin Health, Melbourne and at The Alfred Hospital, Melbourne and by a small number of other centres on a case by case basis. These centres have strict eligibility requirements that have been set by the hospital’s ethics committees that govern who is allowed to be included in the study depending on their individual MS status. It is for this reason patients need to be referred to these centres by a neurologist, who can provide a detailed clinical history and MRI findings to assist in selecting the most appropriate candidates for treatment.
International studies to date have suggested that people with progressive forms of MS, experience reduced benefits from AHSCT, with a greater risk of serious adverse events. It is therefore unlikely that AHSCT would be recommended as a treatment for patients with secondary progressive or primary progressive MS. Each person’s situation is unique and decisions about any MS treatments, taking into consideration the potential benefits, risks and side effects for an individual’s particular circumstances, should be made in careful consultation with each individual’s neurologist.
MS Research Australia has prepared comprehensive information available for people with MS who may wish to learn more about this form of treatment.