The aHSCT treatment

How and why can the 'Hematopoietic Stem Cell Transplantation' stop Multiple Sclerosis?
The aHSCT treatment works because the memory of the immune system is completely or partially erased.

Stem cell therapy
aHSCT stands for autologist hematopoietic stem cell therapy.
This treatment uses autologous stem cells that are present in the bone marrow and in the blood, so-called hematopoietic cells. Autologous means that the person's stem cells are used.

The purpose of aHSCT is to "reset" the immune system so that inflammatory cells no longer attack the myelin in the brain and bone marrow, as is the case with people with an active form of MS. Stem cells are very important for repairing damage in the human body. Various other types of cells can arise from stem cells. In this case blood stem cells are used, which can form different types of inflammatory cells and thus rebuild the immune system. However, this type of stem cell cannot repair organs or tissues. HSCT therefore cannot repair real nerve damage (dead nerves).

How does aHSCT work with MS?
The lesions in MS have been infiltrated with blood-derived immune cells. This also includes T and B lymphocytes that appear to attack and damage myelin producing cells. We do not know what caused this attack, but the process almost certainly involves the improper functioning of the immune system. The purpose of aHSCT in MS is to purify the existing immune system with immunosupressive chemotherapy and to generate new, healthy immune cells through aHSCT. This process is, very ingeniously, called "resetting of the immunological clock". This means that in principle adult cells of the immune system that attack the brain can be eliminated and replaced with new, harmless cells. Recent research has shown that this "resetting" of the immune system actually takes place and that the thymus (thymus), the organ where hematopoietic progenitor cells develop into adult T lymphocytes, is reactivated after aHSCT. This increases the number of T cells, including possibly "regulatory" T cells that suppress the autoimmune attacks.

What can aHSCT do for people with MS?
Thousands of people around the world have already undergone an (autologous) hematopoietic stem cell transplant. Although randomized controlled trials, which accurately determine effectiveness, have not yet been completed, the analysis of the results reported so far gives an indication of what can and cannot be achieved with this treatment. First of all, aHSCT has generally shown a positive effect on the suppression of inflammation and the development of new plaques as demonstrated by MRI in an average 80% of patients. A majority of the people treated stabilized and even improved the existing neurological disability. Although stem cells can in principle transform into any progeny of a cell, including neural or myelin producing cells, we do not know whether stem cells can actually help restore neural structures that have already been damaged by MS.