Autologous hematopoietic stem cell transplantation for relapsing-remitting multiple sclerosis: A single-center institutional care protocol
DOI:
https://doi.org/10.46765/2675-374X.2025v7n1e322Keywords:
Multiple sclerosis, Stem cell transplantation, Clinical protocolAbstract
Relapsing-remitting multiple sclerosis (RRMS) may remain clinically and radiologically active despite sequential exposure to high-efficacy disease-modifying therapies. In carefully selected patients with highly active inflammatory RRMS, autologous hematopoietic stem cell transplantation (AHSCT) has demonstrated superior inflammatory control and durable rates of no evidence of disease activity, with low treatment-related mortality rates in experienced centers. AHSCT promotes immune renewal through high-dose immunoablation followed by autologous stem cell rescue, aiming to restore immune tolerance. Here, we describe a structured institutional standard-of-care protocol for AHSCT in RRMS, developed to support safe referrals and harmonize neurology-hematology collaboration within a Brazilian tertiary center. By consolidating a transparent and safety-focused care pathway aligned with national and international guidance, this manuscript aims to facilitate standardized patient selection, optimize risk mitigation, and strengthen multidisciplinary communication between referring neurologists and transplant teams.
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Copyright (c) 2026 Pedro D'elia Machado Silva, Stephanie Jauquin de Abreu, Alini Vargas, Maria Cecilia Aragon de Vecino
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