Hematopoietic stem cell transplantation for multiple sclerosis: finding equipoise

Hematopoietic stem cell transplantation of multiple sclerosis is rapidly expanding. Success for this approach requires an understanding of the pathophysiology of multiple sclerosis and design of trials that select patients with active inflammatory disease, low disability scores, and avoidance of conditioning agents that may damage neural stem cell compartments or further compromise already injured axons.