Autologous Hematopoietic Cell Transplantation in Multiple Sclerosis: Changing Paradigms in the Era of Novel Agents

Figure 1

Outline of AHSCT. Key steps of AHSCT include the following. Leukapheresis: mobilization of hematopoietic stem cells following administration of cyclophosphamide and granulocyte-colony stimulating factor (G-CSF). The autologous graft that is harvested from the peripheral blood by leukapheresis is then cryopreserved. Conditioning: a cytotoxic high-dose conditioning regimen is administered during hospitalization for AHSCT. Transplantation: the autologous hematopoietic graft is then reinfused (transplantation), and supportive care is provided during hospitalization for neutropenia until engraftment. Engraftment: following engraftment, close outpatient monitoring and prophylactic treatment are necessary.