TagHSCT

Adenovirus infection after HSCT

Adenovirus is pretty common in the general population, responsible for the common cold, sore throat, bronchitis, diarrhea and conjunctivitis. It is harmless in most instances and like the herpes virus, most of us remain latently infected. During periods of immunosupression, however, the adenovirus can reactivate causing untoward trouble. The latter can range anywhere from organ-specific...

HSCT Units can you please show me the data?

Barts-MS rose-tinted-odometer  0/★ I am often asked why given the extraordinary efficacy of HSCT in early RRMS, but not advanced MS, why I don’t refer more of my patients for HSCT early on in the course of their disease. There are several reasons these are the main ones.  Firstly, to be eligible for HSCT under our London guidelines patients have to fail at least two DMTs one of which has to be a...

Chicken or Egg?

Rose-tinted-odometer = ★ Brain Health is a major theme of this blog. Why?  We think that to ‘maximise brain health for the life of a person with MS (pwMS)’ we need to manage MS actively and holistically and promote brain-healthy behaviours. The ‘we’ here is not only HCPs but you and society, which includes regulators, politicians, educationalists, pharma, etc.    Another thing...

Killjoys peddle fake news

For all the killjoys out there DMTs do work, i..e. they modify the course of MS and prevent you from reaching all disability milestones including the time to diagnosis of SPMS and EDSS 10.0 or death. Please don’t listen to the zealots who are trying to spin fake news that the only treatment to prevent the development of progressive MS is HSCT; they are wrong. There are other options; the study...

Are IRTs ahead of their time?

I am beginning to think that immune reconstitution therapies or IRTs are ahead of their time. Many neurologists, people with MS (pwMS), payers – particularly fee-for-service insurance companies – and the regulators are unable to get their heads around how these agents work. In addition, a few recent review articles, written by colleagues, cast doubt on this treatment strategy and the...

HSCT and fake news

I post to manage expectations and counteract fake news.  There is a group of pro-HSCTers going around and saying HSCT is a cure for MS even in MSers with more advanced disease, i.e. it halts and reverses their disability. This is simply not correct and we have no published, peer-reviewed, data to support their position.  The meta-analysis below from Paulo Muraro and colleagues clearly...

HSCT in MS, more a remission than a cure

In a prose to seduce the weary palate, the British neurologist, I recollect saying: “What should be the aims of HSCT treatment? At worst, remission. At best, a cure“. I may just have to eat my words… In a small study from Uppsala University (n=45), Larsson et al. report the effects of HSCT on neuronal damage (using neurofilament levels) and inflammation (IgG index and...

HSCT, is it remission, or is it a cure for MS?

Most of you who read the blog know that I’m highly cynical when it comes to the word ‘CURE’ in the same sentence as a brain disorder or autoimmunity. In fact, it’s very similar to hearing the word VEGAN in the same sentence as pizza or donuts (apologies to any vegans who are currently sitting across from one of these right now; there’s always tomorrow). Why? Where do...

AAN 2019 posters #2

Well, here is part deux of the 2019 AAN posters; a veritable smorgasbord of hidden gems on Market St in Philadelphia. 1. Effect of Ibudilast on Neurofilament light chain in Progressive MS Analysis from a Phase II Trial. Fox et al. Cleveland Clinic.Previous results from the SPRINT-MS study that used 80-100mg/day of Ibudilast, showed slowing of the progression in brain atrophy (i.e. volume loss) by...

1st-line HSCT

If push came to shove would you really choose HSCT as a first-line treatment to treat your MS? When asked on the blog yesterday which DMT would I choose if I had MS, I chose HSCT. One of my patients, who I have been looking after for over a decade, sent me an email stating how upset she was that I had never offered her HSCT. I clearly need to explain my position so as not to upset anyone else...

Translate

Categories

Recent Posts

Recent Comments

Archives