CHOOSING AN HSCT FACILITY
It is necessary to explore which type of HSCT (Myeloablative or Non-Myleoablative) is best for you. Furthermore, information and understanding, will help you to decide which facility is best to treat your MS. Myeloablative HSCT has, formerly been considered the most effective form of HSCT for progressive patients. It should be noted that Primary Progressive MS and Secondary Progressive MS do not show active inflammation. This is one of the main criteria to qualify for HSCT. Because of this they are often rejected as candidates for HSCT. This view was established by Dr. Burt in his early studies and continues to be supported by the EBMT.
MOST FACILITIES ARE NON-MYLEOABLATIVE
Unfortunately, the only facilities currently treating progressive forms are Russia, Israel and Mexico. These facilities whom perform the Non-Myleoablative form of treatment. HSCT for autoimmune diseases, has been performed throughout the world for almost thirty years. The very first procedures were performed in the early nineties. The procedure has been finessed considerably since its first inception, honed and customized in many subtly different ways. All have their own merits. It should be noted that Dr. Federenko in Russia has enjoyed some amazing results for PPMS patients. Dr. Federenko has developed his own specific protoco, which would fall into the Non-Myleoablative category.
DR. BURT AT NORTH WESTERN, CHICAGO
North Western Memorial Hospital Chigago is where Dr. Burt (considered the father of HSCT) treats patients. There are provisions for insurance at this facility. If you are accepted under Dr. Burt’s criteria, his team can apply for insurance to cover the cost of HSCT.
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 throughout the World, 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. Consequently, progressive patients were rejected out of hand for further studies. This established the EBMT Guidelines as they stand today. As discussed earlier there are some phenomenal results for progressive forms of MS coming out of Russia. The success of Dr. Ferdorenko and his customized HSCT, raise new questions about the validity of these early findings. New developments every day, reinforce the mantra of this site: HSCT STOPS DISEASE PROGRESSION IN ALL TYPES OF MS!