BACKGROUND: Allogeneic hematopoietic cell transplantation (allo-HCT) has been proposed as treatment for multiple sclerosis (MS) and other autoimmune diseases.
AIMS: To
describe the effects of allo-HCT on the course of MS in a 49-year-old
woman with longstanding progressive MS who was treated with allo-HCT for
follicular lymphoma.
METHODS: Non-myeloablative
conditioning allo-HCT, examination for IgG oligoclonal bands and
measurement of CXCL13 and matrix metalloproteinase-9 (MMP-9)
concentration in the cerebrospinal fluid (CSF).
RESULTS: Despite the disappearance of oligoclonal bands in CSF, disease progression and CSF inflammation was observed.
CONCLUSIONS:We
hypothesize that CXCL13 and MMP-9 detected in CSF may reflect ongoing,
pathogenic immune activation even after the eradication of intrathecal
IgG synthesis. This suggests that progressive MS may depend more on
innate than on adaptive immune activation.
An allogenic heamatopoietuc cell transplantation is essentaily having a bone marrow transplant from someone that you are not related to. Whilst the transplant was not to erradicate the MS it was to get rid of tumours, They did not reradicate the immune system in the pre-treatment (conditioning), but it did reduce the activity of reducing the oligoclonal bands but this did not stop the MS They suggest this is therefore evidence that progression is not due to the action of T and B cells. We think this already from the failure of T and B cell therapies to inhibit non-relapsing aspects of progression.