Autologous Mesenchymal Stem Cell Transplantation in Multiple Sclerosis: A Meta-Analysis

Area of Science:

• Neurology
• Immunology
• Regenerative Medicine

Background:

• Multiple sclerosis (MS) is a chronic CNS inflammatory demyelinating disease impacting over 2 million globally.
• Current treatments aim to manage symptoms and slow disease progression.

Purpose of the Study:

• To evaluate the safety and efficacy of autologous mesenchymal stem cells (aMSCs) for treating MS.
• To analyze transplant-related mortality (TRM), disease progression rates, and no evidence of disease activity (NEDA) status.

Main Methods:

• A meta-analysis of nine studies involving 133 MS patients.
• Searched PubMed, Embase, Cochrane, Web of Science, and Clinical Trials databases (September 2019).
• Utilized RevMan and R's metaprop for efficacy and safety assessments.

Main Results:

• Pooled TRM was 0% (95% CI 0%-0.3%), indicating high safety.
• Disease progression rates were 16% at 6 months and 35% at 1 year.
• Intrathecal aMSC injection significantly correlated with lower progression rates (p=0.02 at 6 months, p=0.003 at 1 year).
• NEDA status was achieved by 72% at 6 months and 62% at 1 year.
• Pooled NEDA at 6 months was 72% (95% CI 58%-89%) and at 1 year was 62% (95% CI 42%-81%).

Conclusions:

• Autologous mesenchymal stem cell transplantation is a safe therapeutic option for MS patients.
• Intrathecal administration of aMSCs demonstrated the most favorable outcomes in MS treatment.
• Further research into aMSC therapy for MS is warranted, particularly focusing on delivery methods.