Автологическая трансплантация стволовых клеток для лечения множественных склерозов и оптовоза нейромиелита - рекомендации ECTRIMS и EBMT.
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Muraro Paolo A, Mariottini Alice, Greco Raffaella, Burman Joachim, Iacobaeus Ellen, Inglese Matilde, Snowden John A, Alexander Tobias, Amato Maria Pia, Bø Lars, Boffa Giacomo, Ciccarelli Olga, Cohen Jeffrey A, Derfuss Tobias, Farge Dominique, Freedman Mark S, Gaughan Maria, Heesen Christoph, Kazmi Majid, Kirzigov Kirill, Ljungman Per, Mancardi Gianluigi, Martin Roland, Mehra Varun, Moiola Lucia, Saccardi Riccardo, Tintoré Mar, Stankoff Bruno, Sharrack Basil, Attendees of the ECTRIMS Focused Workshop on HSCT
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Оригинал публикации
Autologous haematopoietic stem cell transplantation for treatment of multiple sclerosis and neuromyelitis optica spectrum disorder - recommendations from ECTRIMS and the EBMT.
Autologous haematopoietic stem cell transplantation (AHSCT) is a treatment option for relapsing forms of multiple sclerosis (MS) that are refractory to disease-modifying therapy (DMT). AHSCT after failure of high-efficacy DMT in aggressive forms of relapsing-remitting MS is a generally accepted indication, yet the optimal placement of this approach in the treatment sequence is not universally agreed upon. Uncertainties also remain with respect to other indications, such as in rapidly evolving, severe, treatment-naive MS, progressive MS, and neuromyelitis optica spectrum disorder (NMOSD). Furthermore, treatment and monitoring protocols, rehabilitation and other supportive care before and after AHSCT need to be optimized. To address these issues, we convened a European Committee for Treatment and Research in Multiple Sclerosis Focused Workshop in partnership with the European Society for Blood and Marrow Transplantation Autoimmune Diseases Working Party, in which evidence and key questions were presented and discussed by experts in these diseases and in AHSCT. Based on the workshop output and subsequent written interactions, this Consensus Statement provides practical guidance and recommendations on the use of AHSCT in MS and NMOSD. Recommendations are based on the available evidence, or on consensus when evidence was insufficient. We summarize the key evidence, report the final recommendations, and identify areas for further research.