Webinar with Dr.Denis Fedorenko №2 (15.12.2018) AHSCT RUSSIA

Webinar AHSCT RUSSIA

Presenter: Dr. Denis Fedorenko
The Leading hematologist of Pirogov National Medical and Surgical Center, MD, PhD, Professor

Assistant: Anastasiya Panchenko
The administrator of the National Medical and Surgical Center named after Pirogov N.I.

Interviewer: Gwen Higgs
Interviewer: Janet Voyce
Interviewer: Ann Wilson

Autologous stem cell transplantation for multiple sclerosis and other autoimmune diseases:
Historical perspective and rationale, clinical and patient-reported outcomes, future directions.

1. Wanted to be treated with the most effective and safe method of HSCT?
- The method allows to completely eliminate groups of autoimmune cells and effects the nature of their formation.
2. You were refused in other places due to the severity of illness?
- The accumulated experience and technologies allows us to successfully cope with SPMS and PPMS, as well as RRMS.
3. You were offered a place in a very long waiting list?
- You do not have to wait years for transplantation. And the therapy itself does not require any special preparation.
4. Worrying about the accommodation and quality of medical care?
- The treatment goes stationary, under 24/7 observation by the leading team of specialists, and takes place in the Department of the world-famous Multidisciplinary Medical-Surgical Center of Russia.

Every application will be personally reviewed by the leading hematologist of Russia:
Dr. Denis Fedorenko, MD, PhD, and within only one week he will respond to you by e-mail.

AHSCT is a type of transplantation that uses the person's own stem cells particularly from peripheral blood.

These cells are collected in advance, stored at sub-zero temperatures, and returned at a later stage, after high dose chemotherapy or immunosupressive therapy.

This approach can stop the progression of the disease in most patients and prevent further decrease of their quality of life.

This is an established treatment for more than 3 decades and clinically approved for hematological malignancies (such as lymphoma, leukemia).

Due to haemopoietic stem cell transplantation, the majority of the patients suffering from tumor blood diseases, who earlier were condemned to rapid death, obtained significant chances for recovery.

As fundamental investigations have shown, the cause for development of autoimmune diseases is impairment of the cells of the immune system.

Autologous hematopoietic stem cell transplantation has nothing to do with the so called "cell therapy" approaches that are popular in Russia nowadays.

Multiple sclerosis patients do not need any maintenance therapy after transplantation.

It was shown that transplantation procedure was well tolerated by the patients.

The core results of this study are presented below.

- Lymphoablative Conditioning:

This procedure intends to eradicate autoreactive immune cells in patient's body, which destroy healthy tissues of the patients and may lead to development of autoimmune diseases.

Chemotherapy dose for this procedure is less than in the established protocol for patients who have lymphoma or leukemia.
The use of less intensive conditioning regimens is supported by the suggestion that AHSCT is not only immunosuppressive therapy, but also may have immunomodulation component.

Moderate intensity and less toxic regimen may induce durable long-term remission, comparable with the high intensity regimens, but without being associated with the higher transplant-related mortality.

We suggest, that the best candidates for transplantation is relatively young patients with active inflammatory lesions of relatively short duration and rapidly progressive disease, but still low disability scores, resistant to conventional therapy.

Cumulative incidence of disease progression was quite low both for RRMS and PrMS. It was higher in patients with progressive course of the disease than in those with relapsing-remitting MS: 21.3% vs 13.2%

For long-term follow-up (median 48.9 months), in the group with RRMS event-free survival rate was 83.3% and in the group with progressive course – 75.5%.