The most effective treatment at halting inflammation in patients with highly active multiple sclerosis (MS) is immune ablation followed by autologous hematopoietic stem cell transplantation (AHSCT). Better patient selection and supportive management, as well as advances in conditioning regimens have resulted in improved safety with AHSCT. However, which comorbidities or prior therapies increase the risks associated with AHSCT still need to be determined. In addition, there is still debate as to which AHSCT conditioning regimen offers the best balance of long-term efficacy and safety. New studies comparing AHSCT with highly effective disease-modifying therapies will help to inform on the ideal placement of AHSCT in the treatment algorithm. Currently, many centers are experienced and use AHSCT to treat select patients with MS, contributing to ongoing registries and clinical trials which will help answer these questions.

中文翻译：

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自体造血干细胞移植治疗多发性硬化症：当前观点

阻止高度活动性多发性硬化症 (MS) 患者炎症的最有效治疗方法是先免疫消融，然后进行自体造血干细胞移植 (AHSCT)。更好的患者选择和支持性管理以及预处理方案的进步提高了 AHSCT 的安全性。然而，仍需要确定哪些合并症或先前治疗会增加与 AHSCT 相关的风险。此外，关于哪种 AHSCT 预处理方案能提供长期疗效和安全性的最佳平衡，仍存在争议。将 AHSCT 与高效的疾病改善疗法进行比较的新研究将有助于了解 AHSCT 在治疗算法中的理想位置。目前，许多中心有经验并使用 AHSCT 治疗特定的 MS 患者，