High dose immunosuppressive therapy with autologous hematopoietic stem cell transplantation in secondary progressive multiple sclerosis: Case report

During the last several years high dose chemotherapy (HDCT) with autologous stem cell transplantation (auto-HSCT) has been established as a therapeutic option for multiple sclerosis (MS) patients. We report clinical and patient-reported outcomes of HDCT + auto-HSCT in a male patient affected by secondary progressive MS (EDSS 5.0 at base-line). Reduced BEAM conditioning regimen was used. As a result, clinical response in terms of reduction of disability and disease activity was achieved along with quality of life (QoL) treatment response and symptom treatment response. The patient was off immunosuppressive or immunomodulating therapy throughout the post-transplant period. Our findings demonstrate that HDCT+auto-HSCT might be considered as an effective treatment for MS patients with high disease activity and relatively low disability rate. Reduction of dose intensity seems to have no influence on treatment outcome. QoL and symptom measurement appears to be an effective approach to assessment of treatment outcomes in patients with MS.