HSCT and COVID-19 Mexican Style

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I know there is great interest in HSCT and I also know any posts on HSCT is like catnip to the zealots. So I can’t be bothered to engage or defend as no matter what one says it is going to be wrong if is says something that people don’t want to hear. Removing your immune system puts you at serious risk from infection. Once you immune systme regenerates the risk goes away. This is simple immunology 101. What happens with HSCT….So here we have a story from Mexico. There is no conflict of interest reported so I have assume that they are not HSCT doctors who take money for performing HSCT, otherwise it would be like turkeys voting against christmas. You can read the abstract and the conclusions. People 6 months after transplant do OK based on a same numer of infected individuals. If we ask what happens 6 months after alemtuzumab I am sure we would get the same answer.

Olivares Gazca JC, Gómez Almaguer D, Gale RP, Ruiz Argüelles GJ. Mélange intéressante: COVID-19, autologous transplants and multiple sclerosis. Hematology. 2020; 25:320. doi: 10.1080/16078454.2020.1802931. 

The pandemic of coronavirus infectious disease-2019 (COVID-19) caused by the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) is a threat to global health. During the pandemic changes in how haematopoietic cell transplant are done are suggested such as avoiding the use of immunosuppressive drugs. From June 2015 to March 2020, we autografted 894 persons with multiple sclerosis (MS) using a conditioning regimen of cyclophosphamide (200 mg/kg (and rituximab (1 g). The first case of COVID-19 in México was diagnosed on 28 February 2020. To determine any interaction between SARS-CoV-2-infection and our program, we studied 13 subjects autografted 2–27 March 2020 during the initial part of the pandemic in México who had negative results of qualitative reverse transcription–polymerase chain reaction (qRT-PCR) tests for SARS-CoV-2 before and after their transplant. We also sent a questionnaire to 894 consecutive transplant recipients, 330 (37%) of whom responded. Four subjects indicated they were infected with the SARS-CoV-2 and developed COVID-19, 6–31 months post-transplant, only 1 of whom was hospitalized for 2 days, not in an intensive care unit. None were treated for COVID-19. Our data suggest, but do not prove, a low risk of developing COVID-19 in autotransplant recipients with MS. We cannot comment on the risk of SARS-CoV-2-infection as most respondents were not tested by qRT-PCR or for anti-SARS-CoV-2 antibodies. Also, there may be a selection bias of respondents.

No potential conflict of interest was reported by the author(s).

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MouseDoctor

12 comments

  • I agree. Going to Mexico for HCST seems a risk too far. Not many can pay the £48k that the very pleasant Caroline Wyatt of the BBC paid either. Was pleased to hear her broadcasting at the weekend (some Radio 4 news programme she heads up. Forget which. Maybe “PM”) so she\s OK. I don’t recall her saying whether it worked. In a newspaper interview last year (or possibly earlier) she’d just come back from there and was very hopeful.

    • “Going to Mexico for HCST seems a risk too far.” “Not many can pay the £48k ”

      Lucky you are doing well you can avoid risk..so many paid from u.k. there’s no room for more pins on the island on their map. It’s been proven superior to all therapies..yes alemtuzamab.

      “I have had ms for 7 years and I have gone within the last year gone from a stick to rollator I’m 35 and it seems I’m deteriorating fast..asking if there was a better medication than Retuximab as I am still deteriorating on this medication”

      “I don’t recall her saying whether it worked.”

      Her progression stopped for awhile..but she’s written that it’s resumed.

  • Seriously? No conflict of interest? This center is well known for accepting money from whoever wants treatment – whether or not they even have MS, I would venture. Also their method of AHSCT is to use low dose chemotherapy and put everyone on Rituximab. I find it hard to believe published data that is accompanied by a “no conflict statement” that is blatantly incorrect.

    • “This center is well known for accepting money from whoever wants treatment – whether or not they even have MS, I would venture.”

      No..they require mri for acceptance. And they do turn away some people.

      Just last week on FB..woman reported her brother was turned away from Russia because mri showed too much damage..and another woman’s daughter was turned away from Mexico because she could no longer move her arms or legs. They both were on multiple DMTs..which didn’t stop progression but cost
      in one year more than total hsct cost.

      You know little about MS and even less about hsct..There’s no advantage in using more chemo to destroy bone marrow as ms is in the brain/spnie not
      the bone marrow..so Mexico/Russia/Dr. Burt all do same non-myelo. And plenty of people non-respond/relapse after myeloablative hsct. Mexico doesn’t put people on rituximab for a year like they used to..but just give one infusion to top off the the process..same as Russia.

      • Dear Anon

        I suggest you retract your words or choose them more carefully. I would suggest that Prof Mark Freedman has performed more HSCT than most people and knows an alot about MS and HSCT and therefore as a supporter of the technique they are better placed than most people to make such comments.

        I have no doubt that some people that are not suitable for treatment, but I dont think this is the point.

        The article came out a week before Black Friday but you have to admit it sounds like an advert….”Roll-Up, Roll-Up get your HSCT here”

        P.S. I have no reason to believe that this is not Prof Freedman Neurologist making the comment

      • “You know little about MS and even less about hsct.”
        Oh dear, omelette on fizzog time. We feel your embarrassment 🙁

    • Seriously Dr Freedman!
      So many Canadians have to leave the country for treatment because we don’t have enough money in our health care system for autoimmune diseases.
      Dr Ruiz is an amazing human being as well as a very caring doctor.
      Hes the 2011 alumnus of the year from the Mayo clinic and number 42 of the top 50 doctors.
      A crook he is not.
      We could be so lucky to have him here in Canada.
      Do your research before you knock him.

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