Brazilian guidelines for bone marrow transplantation

Adoption of bone marrow transplantation as a MS treatment is diffusing widely. #MSBlog #MSResearch

"My recent post on bone marrow transplantation as a treatment for MS generated a large amount of discussion. You may find the following Brazilian guidelines of the use of BMT in MSers of interest. The Brazilians are not alone in their adoption of BMT as a treatment for MS; several centres in Europe, Canada and the USA offer BMT as a treatment for MS." 

Rodrigues et al. Guidelines of the Brazilian society of bone Marrow transplantation on hematopoietic stem cell transplantation as a treatment for the autoimmune diseases systemic sclerosis and multiple sclerosis. Rev Bras Hematol Hemoter. 2013;35(2):134-43.

The consensus on hematopoietic stem cell transplantation (HSCT) in autoimmune diseases provides an indication of HSCT in patients with progressive MS unresponsive to conventional therapy and EDSS between 3.0 and 6.0. The forms of the disease that might benefit from transplantation are: relapsing-remitting, primary or secondary progressive, and the "malignant" form, provided there is evidence of inflammatory activity at the time of transplant indication. The patients should be transplanted preferably in centers with experience in this procedure. Table 1 summarizes the recommendations (modified below).

"The following is an update on the survey I ran regarding whether or not MSers would be prepared to take the risk of having a BMT. Could these results be correct? Over 50% of MSers are prepared to take the risks of BMT. Only 28% have said no. If these result are correct I have seriously underestimated the risk MSers are prepared to take in the hope of a potential cure for their disease."

"Maybe I need to survey neurologists about the same issue? At a personal level I think BMT is too risky as a treatment for MS. In the light of these results, maybe I should reconsider my position?"

"Please have your say!"

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