Exploring the Benefits and Risks of HSCT for Autoimmune Diseases

Louis A. Cona, MD
Updated on
Dec 19, 2022
5

minute read

In this article, we'll take a closer look at HSCT, including how it works, its potential risks and benefits, and how it compares to other treatments for MS.

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Are you or a loved one considering hematopoietic stem cell transplantation (HSCT) for treating multiple sclerosis (MS)?

HSCT is a complex medical procedure involving collecting and storing the patient's stem cells and using chemotherapy to destroy the immune cells attacking the central nervous system. It is generally considered a last resort for people with MS who have not responded to other treatments and have a more severe form of the disease.

But what exactly is HSCT, and how does it compare to other treatment options for MS?

In this article, we'll take a closer look at HSCT, including how it works, its potential risks and benefits, and how it compares to other treatments for MS. We'll also discuss the cost of HSCT and what you can expect during the treatment process. Whether you're just starting to explore treatment options for MS or considering HSCT as a potential option, this article will provide valuable information to help you make an informed decision.

What is HSCT?

Hematopoietic stem cell transplantation (HSCT) is a treatment for some types of cancer and other diseases. Stem cells can come from blood or bone marrow. HSCT aims to reset the faulty immune systems of people suffering from autoimmune diseases by taking hematopoietic stem cells from the patient's bone marrow or blood and wiping out their immune system with chemotherapy. There are three different categories of transplantation: autologous, allogeneic, and syngeneic. AHSCT is considered the safest form of HSCT in MS, and there is growing evidence that aHSCT may be an effective treatment for MS.


What is a Hemetaopetic Stem Cell?

Hematopoietic stem cells (HSCs) are a type of multipotent adult stem cell, characterized by their ability to self-renew and differentiate into erythrocyte (red blood cell) and leukocyte (white blood cell) cell lineages. Hematopoietic stem cell transplantation (HSCT) is a treatment for some types of cancer and other diseases. Stem cells can come from blood or bone marrow and produce the body's cellular components. HSCT may be autologous (the patient's stem cells are used), allogeneic (the stem cells come from a donor), or syngeneic (from an identical twin).


HSCT for Multiple Sclerosis

Hematopoietic stem cell transplantation (HSCT) is a potential treatment option for some people with multiple sclerosis (MS). MS is a chronic autoimmune disease that affects the central nervous system, causing problems with muscle control, vision, and other essential body functions.


What is a hematopoietic stem cell transplant?

HSCT involves collecting a patient's hematopoietic stem cells, found in the bone marrow, and can develop into any blood cell. These stem cells are then stored, and the patient undergoes chemotherapy to destroy the immune cells attacking the central nervous system. The stored stem cells are then transplanted into the patient to rebuild the immune system.

The goal of HSCT for MS is to reset the immune system, which may slow or stop the progression of the disease. It is generally considered a last resort for people with MS who have not responded to other treatments and have a more severe form of the disease.

HSCT for MS is still considered an experimental treatment and is not widely available. It is generally only offered through clinical trials or at specialized centers with experience with the procedure.

It's important to note that HSCT for MS is a complex and potentially risky procedure and is not suitable for everyone. The system's potential risks and side effects include infection, bleeding, and organ damage. It's essential to speak with a medical professional about the potential risks and benefits of HSCT for MS before making a treatment decision.


What are the risks associated with HSCT?

Hematopoietic stem cell transplantation (HSCT) is a complex medical procedure with many potential risks and side effects. Some of the most common risks associated with HSCT include:

  1. Infection: The chemotherapy and immune suppression that occurs before and after the transplant can increase the risk of infection. Patients may need to take antibiotics to prevent or treat infections.
  2. Bleeding: The chemotherapy and immune suppression that occurs before and after the transplant can also increase the risk of bleeding. This may require blood transfusions or other medical interventions.
  3. Organ damage: The chemotherapy used before the transplant can damage the kidneys, liver, and other organs. This can lead to severe complications and may require additional medical treatment.
  4. Graft-versus-host disease (GVHD) is a severe complication that occurs when the donor's immune cells attack the recipient's cells. It can cause many symptoms, including skin rashes, liver damage, and diarrhea.
  5. Rejection of the transplant: In some cases, the recipient's body may reject the donated stem cells, leading to severe complications and additional medical treatment.
  6. Late effects: Some patients may experience long-term side effects of HSCT, such as fertility issues, second cancers, or problems with organ function.


It's important to note that these risks and side effects can vary depending on the patient's age, overall health, and the underlying condition being treated. Speaking with a medical professional about the potential risks and benefits of HSCT before deciding on treatment is essential.


Cost of hematopoietic stem cell transplantation

The cost of hematopoietic stem cell transplantation (HSCT) can be significant, as it involves multiple rounds of chemotherapy and other medications, as well as hospital stays and follow-up care. The exact cost of the procedure can vary depending on several factors, including the patient's age, overall health, and the underlying condition being treated.

The cost of HSCT varies depending on the country, but it is typically around $150,000 in the US. A study done in Mexico found that the actual, detailed cost of HSCT was $48,893.02. The price also varies depending on the type of conditioning regimen used.


Hematopoietic Stem Cell Transplantation Success Rate

The success rate for HSCT varies from study to study, with all studies yielding a moderate rate of success in halting new disease progression in people with MS. 

However, HSCT is reserved for patients with the refractory disease to first-line agents. The autologous HSCT recipients had follow-ups of 1 to 278 months. The allogeneic HSCT recipients had follow-ups of 0.3 to 195 months. Earlier observational case studies focused on the success of HSCT for MS. Patients transplanted for cancer simultaneously had their MS halted. This was an unanticipated side effect of the treatment.


HSCT vs. Mesenchymal Stem Cell Therapy

Hematopoietic stem cell transplantation (HSCT) and mesenchymal stem cell therapy (MSCT) are two different treatments for multiple sclerosis (MS). HSCT is a high-dose immunosuppressant therapy with hematopoietic stem cell support that aims to halt disease activity by destroying and rebuilding the immune system. It involves getting a bone marrow transplant using autologous cells, considered the safest form of HSCT for MS. 

On the other hand, MSCT uses mesenchymal stem cells (MSCs), a subset of adult stem cells, to foster the repair of the central nervous system through tissue integration and differentiation into neural cells. MSCT is a safe, non-invasive treatment option that is more cost accessible than HSCT. MSCs are thought to have immune-modulating properties and may help to reduce inflammation and promote tissue repair.

The main difference between HSCT and MSC therapy is that HSCT involves a more aggressive approach to resetting the immune system. In contrast, MSC therapy is a less invasive option that may help to reduce inflammation and promote tissue repair.


Conclusion

In conclusion, hematopoietic stem cell transplantation (HSCT) and mesenchymal stem cell (MSC) therapy are two potential treatments for multiple sclerosis (MS). HSCT involves collecting and storing the patient's stem cells and using chemotherapy to destroy the immune cells attacking the central nervous system. In contrast, MSC therapy involves injecting mesenchymal stem cells into the patient.

HSCT is generally considered a last resort for people with MS who have not responded to other treatments and who have a more severe form of the disease. At the same time, MSC therapy is a less invasive option that may help to reduce inflammation and promote tissue repair. It's essential to speak with a medical professional about the potential risks and benefits of each before deciding on treatment.

Ultimately, the best treatment option for MS will depend on the individual patient's age, overall health, and the severity of their condition. Working closely with a medical team to determine the most appropriate treatment plan for your needs is essential.

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