This Is MS Multiple Sclerosis Community: Knowledge & Support

If you were going to get the HSCT BEAM protocol, would you have to wait a certain amount of time so your current MS drugs cleared from your system before getting HSCT? Or could you stay on those drugs up to the point you began HSCT treatment?

Thanks.

Nice article link, Lyon. I enjoyed reading it. Thanks for that.

HiCy being one of the ealier protocols (1990's) originally used for some forms of cancer treatment that also showed an immune reboot for autoimmune diseases. At a high enough dose it definitely shows curative efficacy but as indicated in the article it seems to have a reasonably high treatment risk. I "think" that's why the current HSCT immune reset trials use evolved protocols (such as BEAM used in HALT-MS) that more slowly & gently drop the immune system so as to reduce treatment mortality risk. Good news so far is that there have been zero deaths in the phase II trials (three trials in the US and one trial in Canada), interestingly none of which use HiCy. But this info is still great to gain a better understanding of the underlying science!

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Very astute comments, Lyon. Helps to elucidate the relevant issues.

And sorry for my previous mistake. I stand corrected. . . .

Of the current phase II HSCT trials, Dr. Burt's MIST trial at Northwestern utilizes either one, of two different protocols for his treatment regimen. Both of which (may) incorporate the use of cyclophosphamide, as follows:

Fludarabine + Cyclophosphamide or Campath-1h

- or -

Cyclophosphamide + Anti-Thymocyte Globulin (rATG)

So clearly cyclophosphamide has desireable treatment properties (mainly strong lymphoablation, and at higher doses myeloablation) in the right setting and is also a very useful agent.

This may sound silly, but not to cat lover: How long after HSCT treatment can you g back to holding your cat(s)?

Hi Looking88

Although I don't have any pets of my own (just one young child in daycare. . . . which may be something to be more infectiously-concerned about directly following treatment), your question doesn't sound silly to me.

I have heard of no hard-and-fast rule regarding the subject of pets. I think most oncology doctors that oversee HSCT treatment are usually more concerned about farm or wild animals as the main risk factor. The doctors do suggest to remain clear of pets for "a few months." So without any hard data, if I were in the same situation as I was previously, I would probably be more concerned about shaking hands with strangers as opposed to being around my own sequestered pet for the first couple months following the transplant. (HSCT patients need to to take Bactrim antibiotic as prophylaxis for the first six months post-transplant.) After the first couple months I personally would not worry so much about it so long as my pet were not around a lot of other un-restrained pets with exposure risk.

Bottom line. . . . I just used common sense following my transplant as my main defense against possible infectious exposure. (For me, I never had an infectious complication with my (then) compromised immune system.) I can imagine for many people a pet might be the same as a family loved-one. It wouldn't be fair to be separated for such a a long time. For me, I would go for two months post-transplant and be sure my pet had a good bath before getting back together.

BTW Looking88. . . . Sorry to miss noticing your previous post. . . . .

A 6-8 week washout period for existing MS treatment drugs should be fine. I stopped my Avonex 6 weeks prior to treatment and everything worked out fine.

Thank you for both answers.

I just wanted to share this video about HiCy that Scott Turner forwarded to me. Although still quite early in the clinical data cycle (most MS treated-patients only now a year post-treatment), the early results look very promising and positive. I sincerely support this line of work and hope that cyclophosphamide treatment in the future will show comparable results with BEAM stem cell transplantation (now nearly ten years of positive data). Time will tell. But regardless, even now HiCy looks way far ahead of CRAB drug efficacy. I'm all for that!

http://www.youtube.com/watch?v=SuJj52twOdo

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