Evaluation of the Effect of Autologous Hematopoietic Stem Cell Transplant on Symptom Severity Using Msws-12, Amsq and Symptomscreen in Multiple Sclerosis Patients.

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INTRODUCTION Multiple sclerosis (MS) is a complex inflammatory, demyelinating, and neurodegenerative disease of the central nervous system that causes a whole spectrum of neurological disorders as well as patient's perception of an abnormal physical, emotional or cognitive state, associated with a profound decrease in the quality of life of affected patients. Currently, autologous hematopoietic cell transplantation (auto-HSCT) is a validated therapeutic approach and has been shown to be superior to the use of new immunomodulatory agents. However, the impact of auto-HSCT on the symptom severity in patients with MS remains largely unknown. OBJECTIVE Identify the impact of autologous HSCT in the patient's symptom severity in patients with MS in a single institution. MATERIALS AND METHODS A longitudinal, prospective, and single-center study was conducted in our institution, patients treated whit auto-HSCT in 2022 at Clínica Ruiz were included in this study. We employed the Twelve Item MS walking Scale (MSWS-12), the Arm Function in Multiple Sclerosis Questionnaire (AMSQ) and the SymptoMScreen as instruments for the assessment of symptom severity. Patients who could not answer the questionnaire themselves were excluded as well as incomplete questionnaires. auto-HSCT was conducted as outpatients following the “Mexican method”, which employs high-dose both cyclophosphamide and rituximab . RESULTS Sixty-three patients answered the questionnaire before and after the auto-HSCT. The mean age of the cohort was 47 years (SD, ± 10 years), 34 (54%) patients were female and 29 (46%) were males. The median time to follow up was 20.73 months (IQR: 18 - 24). Of the selected patients, 30 (48%) had relapsing-remitting MS, 19 (30%) primary progressive MS, whereas 14 (22%) had secondary progressive MS. The baseline scores from AMSQ and MSWS-12 showed not statistically differences after transplantation, instead some SymptoMScreen subscales: Bladder control, Fatigue, Dizzines, Cognitive function, Depression and Anxiety. When evaluated according to MS type, the main differences pertain to the RRMS group which showed statistically significant differences in the three evaluation tools as seen in table 1. CONCLUSIONS The study suggests that auto-HSCT improves symptom severity in persons with MS.

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