Autologous hematopoietic stem cell transplantation in multiple sclerosis: A 20-year single center's experience in Mexico.
Mario Enrique Rodriguez Estrada1, Luis Molina Carrion1
1Neurology, National Medical Center " La Raza" of the Mexican Social Security Institute
Objective:

To describe the clinical characteristics and clinical outcomes of AHSCT in Mexican patients.

Background:

Autologous Hematopoietic Stem Cell treatment (AHSCT) is an immune reconstitution treatment option for Multiple Sclerosis (MS) that has grown in clinical evidence over the last decades; detailed efficacy and safety data is still lacking, especially outcomes data from low-income countries. 

Design/Methods:
Retrospective single-center observational study of all MS patients that underwent AHSCT in a single reference center in Mexico City from January 2000 to January 2020. 
Results:

We identified 24 patients, of which 22 had at least one year of follow-up after AHSCT and underwent analysis for clinical outcome. The median follow-up time was 85 months (range: 12-267); with a median age of 44.0 years (IR 38-52); 62.8% (n=15) were men and 31.8% (n=7) women; 50% were secondary progressive forms of MS (SPMS), and 27.3% were relapsing-remitting MS (RRMS); 59% (n=13) met the criteria for highly active MS (HAMS). 

The composite score of no evidence of disease activity 3 or NEDA3 (no relapses, no new MRI lesions, and no EDSS progression) was achieved in all the patients at a 24-month follow-up and in 72.1% (n=16) of the patients at the time of the last follow up visit. Relapse-free survival at the last follow-up visit was achieved at 77.3%; MRI event-free survival at 90.9%; Expanded disability status scale score progression-free survival in 95.4%. Only one patient required the re-initiation of disease-modifying therapy.  

There was no treatment-related mortality. One patient was diagnosed with premature ovarian failure.

Conclusions:

AHSCT in Mexican MS patients is an effective and relatively safe treatment option with no mortality and can be performed with a reasonable degree of safety at experienced centers.

10.1212/WNL.0000000000202077