CHOOSING AN HSCT FACILITY
Deciding which type of HSCT (Myeloablative or Non-Myleoablative) is more suited to you and your own situation will help inform you as to which facility is more appropriate to treat your MS. It is the general consensus that if you have a progressive form of MS (PPMS or SPMS) Myleoablative HSCT is the most effective treatment. Unfortunately the only places currently treating progressive forms are Russia, Israel and Mexico all of whom perform the non-myleoablative type. It has to be said that Dr. Federenko in Russia has achieved some amazing results for PPMS patients that he has treated with his own specific protocol. In Europe, due to an organization known as EBMT – https://www.ebmt.org/Contents/Pages/Default.aspx. which has formulated a standard treatment criteria to regulate and compare results from patients treated, most facilities will only treat MS patients with Relapse remitting MS, with at least 2 failed DMDs (disease modifying drugs) and current MRI’s that show active lesions and inflammation. This is also true of South Africa, and Singapore as well as Germany and Italy. (See Facilities). I personally believe this to be a sad state of affairs as their decision hinges heavily on very early trials for HSCT where a proportion of PPMS and SPMS patients were included, but ultimately on reflection were older and in many cases sicker, with high EDSS (Expanded Disability Status Scale —http://en.wikipedia.org/wiki/Expanded_Disability_Status_Scale) Scores. The results unsurprisingly did not bode so well for the progressive patients and these were rejected out of hand for further studies. This contributed to the EBMT Guidelines as they stand today. It is worth noting that phenomenal results coming out of Russia for PPMS patients disprove these early findings and also reinforce the mantra of this site: HSCT STOPS DISEASE PROGRESSION IN ALL TYPES OF MS!