Evidence map›Paper›PMID 37748927›Full record

Observational studyJournal of neurology, neurosurgery, and psychiatry2024

Haematopoietic stem cell transplantation for treatment of relapsing-remitting multiple sclerosis in Sweden: an observational cohort study.

Thomas Silfverberg, Christina Zjukovskaja, Per Ljungman, Adjmal Nahimi, Erik Ahlstrand, Arta Dreimane, Sigrun Einarsdottir, Jan Fagius, Ellen Iacobaeus, Hans Hägglund and 10 more

Open access · hybridAbstract readObservational Study
In one paragraph

Observational study in Journal of neurology, neurosurgery, and psychiatry, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.

0numbers the graph read from it
0cells of the map it votes in
12citing papers in PubMed
6.9field-weighted citation impact, top 3% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

12 citing papers in PubMed, 27 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

20 authors at 9 institutions in 1 country.

Thomas SilfverbergMedical Sciences, Uppsala universitet Medicinska och farmaceutiska vetenskapsomradet, Uppsala, Sweden.ORCID 0000-0002-3829-285X
Christina ZjukovskajaDepartment of Medical Sciences, Uppsala University, Uppsala, Sweden.
Per LjungmanDepartment of Medicine Huddinge, Karolinska Institutet, Stockholm, Sweden.
Adjmal NahimiDepartment of Neurology, Rehabilitation Medicine, Memory Disorders, and Geriatrics, Skåne University Hospital Lund, Lund, Sweden.
Erik AhlstrandDepartment of Medicine, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
Arta DreimaneDepartment of Hematology, Linköping University Hospital, Linkoping, Sweden.
Sigrun EinarsdottirInstitute of Medicine, University of Gothenburg, Gothenburg, Sweden.
Jan FagiusDepartment of Medical Sciences, Uppsala University, Uppsala, Sweden.
Ellen IacobaeusDepartment of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
Hans HägglundDepartment of Medical Sciences, Uppsala University, Uppsala, Sweden.
Niclas LangeDepartment of Medicine, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
Stig LenhoffDepartment of Hematology, Oncology & Radiophysics, Skåne University Hospital Lund, Lund, Sweden.
Jan LyckeDepartment of Clinical Neuroscience, Institute of Neuroscience and Physiology, Sahlgrenska Academy, Gothenburg, Sweden.ORCID 0000-0002-7891-8466
Johan MellergårdDepartment of Neurology, Linköping University, Linköping, Sweden.
Fredrik PiehlDepartment of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
Anders SvenningssonDepartment of Clinical Sciences, Karolinska Institutet Institutionen för kliniska vetenskaper Danderyds sjukhus, Stockholm, Sweden.
Andreas TolfDepartment of Medical Sciences, Uppsala University, Uppsala, Sweden.ORCID 0000-0002-0580-8821
Honar CherifDepartment of Medical Sciences, Uppsala University, Uppsala, Sweden.
Kristina CarlsonDepartment of Medical Sciences, Uppsala University, Uppsala, Sweden.
Joachim BurmanDepartment of Medical Sciences, Uppsala University, Uppsala, Sweden joachim.burman@uu.se.
Uppsala University · SEKarolinska University Hospital · SEÖrebro University · SESkåne University Hospital · SEDanderyds sjukhus · SELinköping University · SELinköping University Hospital · SESahlgrenska University Hospital · SEUniversity of Gothenburg · SE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundA growing evidence base supports the use of autologous haematopoietic stem cell transplantation (aHSCT) for treatment of relapsing-remitting multiple sclerosis (RRMS), but it has not yet been integrated into most national clinical guidelines. The objective of this study was to assess efficacy and safety when aHSCT is implemented in routine healthcare.

methodsWe assessed 231 patients and the final analysis included 174 RRMS patients who were treated with aHSCT in Sweden before 1 January 2020. Efficacy was evaluated by performing a retrospective analysis of prospectively collected data from the Swedish MS registry. Procedure-related safety was assessed by analysing data from electronic patient records covering a period of 100 days following aHSCT.

resultsWith a median follow-up time of 5.5 (IQR: 3.4-7.5) years, the Kaplan-Meier estimate for no evidence of disease activity was 73% (95% CI 66% to 81%) at 5 years and 65% (95% CI 57% to 75%) at 10 years. Out of the 149 patients with baseline disability, 80 (54%) improved, 55 (37%) were stable and 14 (9%) deteriorated. The mean number of adverse events per patient was 1.7 (±SD: 1.5) for grade 3 events and 0.06 (±SD: 0.3) for grade 4 events. Febrile neutropenia was the most common adverse event, affecting 68% of patients. There was no treatment-related mortality.

conclusionsTreatment with aHSCT for RRMS is associated with freedom from disease activity in a majority of patients, with acceptable adverse events. This procedure should be considered a standard of care for patients with highly active RRMS.

Indexed as

Hematopoietic Stem Cell TransplantationMultiple SclerosisMultiple Sclerosis, Relapsing-RemittingCohort StudiesHumansRetrospective StudiesSwedenTransplantation, AutologousTreatment OutcomeCLINICAL NEUROLOGYHAEMATOLOGYMULTIPLE SCLEROSIS

Identifiers

PMID37748927
PMCPMC10850659
OpenAlexW4387025557

What OpenQuestion holds

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LicenceCC BY-NC
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.