THUR 194 Autologous haematopoietic stem cell transplant in ms

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IntroductionAutologous haematopoietic stem cell transplantation (AHSCT) is a very effective treatment in patients with highly active relapsing remitting multiple sclerosis (RRMS) who failed standard disease modifying therapies (DMTs).MethodsWe retrospectively reviewed the medical records of all patients with RRMS who received AHSCT in Sheffield.Results25 patents with RRMS received AHSCT between July 2013 and July 2017. Their median age at diagnosis was 40 (22–56) years. All had highly active disease with gadolinium enhancing lesions on their pre-transplant MRIs. Eighteen patients had previously been treated with various DMTs and seven were treatment naïve. Median pre-AHSCT EDSS was 5.5 (2.5–7.5). Median follow up was 12 (3–42) months. Median post-AHSCT EDSS at the last follow up was 3 (1–6.5), p<0.001. No patient experienced further relapses following transplantation. Three patients had new lesions on their first follow up MRI at 6 months, but none had any new or enhancing lesions on subsequent MRI scans. Only routine transplant related toxicities were observed. One female and the wife of a male patient successfully conceived following AHSCT.ConclusionAHSCT is safe and effective in inducing remission in patients with highly active RRMS. Further studies are required to compare its efficacy with standard DMTs.

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