HSCT is a plausible treatment paradigm for MS patients. However, auto-HSCT is considered to be a sledgehammer approach for treating MS patients, one that will be astoundingly effective when used on appropriately selected patients. The reasons for this promising therapy’s success are its lower toxicity and its ability to replace the immune system. The future of HSCT trials should discover novel therapeutic strategies that prevent ongoing neurodegeneration and demyelination in progressive MS. The trial designs should consider the reproducibility of HSCs with sufficient yield and purity, select MS patients with active inflammatory disease, and use appropriate conditioning agents.
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