The Quality of Life of Persons with Multiple Sclerosis Improves after Autologous Haematopoietic STEM Cell Transplantation

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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 (ASCT) is a validated therapeutic approach and has been shown to be superior to the use of new immunomodulatory agents. However, the impact of ASCT on the quality of life of patients with MS remains largely unknown. OBJECTIVE Identify the impact of autologous HSCT in the quality of life in patients with MS in a single institution. MATERIALS AND METHODS A quasi-experimental, longitudinal, prospective and single-center study was conducted in our institution. The quality of life was determined in patients with MS before and one year after ASCT; it was determined by applying the MS-QoL 54 instrument which is a validated instrument for this pathology. The variables related to the physical and mental components of the instrument as well as demographic characteristics were studied. Patients who could not answer the questionnaire themselves were excluded as well as incomplete questionnaires. ASCT was conducted as outpatients following the “Mexican method”, which employs high-dose both cyclophosphamide and rituximab . RESULTS 53 patients answered the questionnaire before and one year after the ASCT. 33 (62.26%) were female. Mean age was 48 years (SD ± 9.3). Of the selected patients, 32 (60.37%) had relapsing-remitting MS, 14 (26.41%) primary progressive MS, whereas 7 (13.2%) had secondary progressive MS. The physical and mental components were analyzed between the quality of life in the patients prior to the ASCT and the follow-up after one year. In the energy component the differences observed before and one year after the ASCT were statistically significant (40.30 vs 50.86, p = 0.004), as well as the differences in the role limitations due to physical problems (30.18 vs 45.75, p = 0.20), health perceptions (48.30 vs 56.50, p = 0.017), cognitive function (64.90 vs 74.72, p = 0.003), health distress component (41.60 vs 59.15, p = <0.001), chance in health (33.54 vs 64.62, p <0.001) and the physical health component (49.44 vs 57.21, p = 0.018). On the other hand, in the mental component the differences between before and after one year of ASCT were not statistically significant (p = 0.069). CONCLUSIONS The study suggests that ASCT improves some aspects of the quality of life of persons with MS.

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