Autologous hematopoietic stem cell transplantation in a person with highly active relapsing-remitting multiple sclerosis
Ana Abičić1, Borislav Radić2, Ivan Adamec 3,4
ABSTRACT - Objectives: To present a patient treated with autologous hematopoietic stem cell transplanta- tion (AHSCT) for relapsing-remitting multiple sclerosis (RRMS) and to discuss the role of AHSCT in the treatment of RRMS. Case description: A 36-year-old patient was diagnosed with RRMS at the age of 19 and treated with AHSCT at the age of 21, after failure of the first-line disease-modifying therapy (DMT). Before the treatment, multiple relapses caused disability accumulation resulting in Expanded Disability Status Scale (EDDS) score of 6.0. Results: An improvement in EDSS score from 6.0 to 3.0 was noted following the trans- plantation, with low clinical and magnetic resonance imaging activity during the 15 years of follow-up. No serious adverse events or complications of the treatment were noted, and the patient has been ambulatory without support to date. Conclusion: AHSCT is a treatment option for highly active RRMS refractory to DMT. Careful patient selection and balance between risks and benefits is crucial for successful treatment.