It is not strictly necessary. We treat all kind of patients despite lesions or despite the kind of multiple sclerosis. We think that our main goal is to offer a therapeutic option to the patient, regarding the results in good numbers. Nevertheless, we still have, if not the same, even better results than other HSCT centers. Other centers only treat patients with active lesions because this assumes the best results for these trials, however, we have seen that HSCT, using our method, has results for all type of multiple sclerosis regardless of the level of activity, which is present prior to the treatment.
MRI images are not used to elect the patients, they are however required to have the complete medical chart and to have evidence to make comparisons between before and after the transplant.
We have experience treating both hematological and non-hematological conditions. In the case of neurological diseases or immune neurological diseases we treat Multiple sclerosis, CIDP and NMO. However, we have a large experience, also, treating hematological malignancies such as myelomas, Leukemias, Lymphomas and some other types of solid cancers.
The doses of chemotherapy employed could cause infertility in some cases. There is no way to predict who could develop this condition. It is advisable to get in contact with your general practitioner to find out if freezing, for example the sperms, in the case of male patients, could be necessary.
Its purpose is to have a complete image of the central nervous system before the treatment and accordingly to comply with international standards.
Yes. After grafting more than 500 patients, we have found that our results are similar, if not better, than those reported form other centers which divide the doses of Cyclophosphamide in a different way. As to now, we have found that the EDSS score improves in 41% of patients using our method, it remains stable in 40% of patients and the EDSS progresses in around 19% of patients. This is in the first 3 months after transplant. It is possible that the results are better after this period. As a result of making a little different the way to deliver the Cyclophosphamide, only 2% of patients have been hospitalized, the mortality rate is 0.2%, only one patient has had a serious complication and no patient has had a serious infection. These results are substantially better and safer that those obtained using other ways to deliver the chemotherapy.
Neutropenia can be achieved, either on the hospital or as outpatient. Neutropenia developing in a hospital is much more dangerous because nosocomial acquired infections are more severe and endowed with higher morbid mortality, this is the reason why we try to keep all the patients outside of the hospital, to reduce the complications of the delivery of chemotherapy.
Yes, you are eligible for treatment if you have secondary progressive multiple sclerosis. In our experience using our method, we have found good results in all types of multiple sclerosis including this variety.
Using our method after grafting more than 500 patients, we have found that the best results are in primary progressive and relapsing remitting multiple sclerosis, however, we have also found good results for secondary progressive multiple sclerosis. This is very important because the overall results indicate that patients do have some type of response in 80% of cases; 40% of them improve the condition, 40% of them remains stable and this makes the total of 80%.
Yes, it is quite possible, however, not all patients, given these doses of chemotherapy, loose their hair. Probably, more than 50% will lose their hair, however, there is no relationship between the degree of neutropenia achieved by the delivery of the chemotherapy with the loss of hair, and there is no relationship between losing your hair and having an effective transplant.
You will be back to your normal life pretty soon. While being here you will be given very specific instructions about what to do and what not to do, how to be with your pets, how to expose to flowers, the type of food that you will need to avoid during some period after the transplant, etc. You don’t have to worry about this because you will be given very detailed information about this topic, but you will be back to your life pretty soon, that is one of the goals of our method, to make the patient strong enough to go back to work as soon as possible.
In our hands the neutropenic period takes about 7 to 10 days, during that period, you will be given specific instructions, here, to avoid dangers. And accordingly, you don’t have to worry about this, we will take care of this while you being here.
The salient risks are infections that can occur during the neutropenic period and bleeding that can occur during the thrombocyte of the neutropenic period. However, in our hands, these two periods can be supported on an outpatient basis and the risk of serious infections is very low. The rate of severe infections is 0% and the rate of abnormal bleeding using our method, is also 0%. It has to be mentioned that our mortality rate after having transplanted more than 500 patients is 0.2%.
No, we have been working together for more than 20 years in different areas of hematology. Dr. Ruiz Argüelles and Dr. Gomez-Almaguer were recently granted the Distinguished Service Award by the Center for International Blood and Marrow Research and have been transplanting patients for more than 20 years using the same methodology. In the case of patients transplanted because of multiple sclerosis we are using the exactly the same method, since we have two different venues, there might be minor differences, but, the method, the doses of chemotherapy, the weight to support the patients and the results are exactly the same.
EDSS stands for Expanded Disability Status Scale. We use this international method to assess the degree of severity of the disease, and most importantly, to find out how patients are doing. If you transplant a patient with an EDSS of 7, for example, and after 3 months the patient goes to 5, that indicates good result. EDSS is the best way to assess both, the degree of severity of the disease and the efficacy of the results; this score is used worldwide to classify and follow up, and this is why we use it both, here in Puebla and in Monterrey.
Yes, as you know the main goal of the HSCT procedure in a patient with multiple sclerosis, is to shut down the immune system and to have it recovered from very low levels to normal levels, and since it goes down, the patient loses the ability to defend against several bacteria, virus and so on. This is why we recommend an specific vaccination schedule which you will be given while being here. Most transplant centers all over the world do recommend this vaccination schedule.
That is a very important question. The only way to analyze the results of certain therapeutic procedures is by analyzing the properly using statistics and eventually publishing the experiences. This is our case, our experience using this “Mexican Method” to conduct hematopoietic stem cell transplantation in multiple sclerosis is already in the press. In addition to this publication we have presented our experiences in international congresses in England in the congress of the American Society of Hematology, in the congress of American Society of Bone Marrow Transplantation and in the Latin American Congress of Transplants. So, the only way to prove that our method works is by publishing it and by allowing other researchers to use it and prove that it works in their hands. This is one of the reasons why, since the beginning we elected to register our method in the clinical trials registry so that anybody can use our method irrespective of the place where they are living or working.